Doctor Name: | STEPHEN TAYLOR LAKE |
NPI Number: | 1689620106 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MPT |
License Number: | |
Business Practice Address: | 515 Benjamin Way Suites 304 & 306 Dalton, GA - 307214664 |
Business Phone Number: | 7032788066 |
Business Fax Number: | 7032788187 |
Mailing Address: | 515 Benjamin Way, Suites 304 & 306 DALTON |
State: | GA |
Postal Code: | 307214664 |
Phone Number: | 7032788066 |
Fax Number: | 7032788187 |
NPI Enumeration Date: | 05/26/2006 |
NPI Last Update Date: | 02/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |