Most Relevant Information
Provider Data
| NPI Number: | 1003300252 |
| Provider Name: | ALEXANDRA L LAKE |
| Entity Type: | Individual |
| Taxonomy Code: | 156F00000X |
| Specialty: | Technician/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/20/2018 |
| Last Updated: | 06/20/2018 |
Provider Practice Location
32100 TELEGRAPH RD STE 205
BINGHAM FARMS
MI
480252454
Practice Location Phone/Fax
| Phone: | 2487124266 |
| Fax: |
Provider Mailing Location
32100 TELEGRAPH RD STE 205
BINGHAM FARMS
MI
480252454
Provider Mailing Phone/Fax
| Phone: | 2487124266 |
| Fax: |