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Search › Ohio › 207P00000X

Justin Lake

NPI 1710410998 · on the registry since 2017

Practice

Address
405 W Grand Ave
Dayton, OH 45405
Phone
(937) 723-3245
Organisation at this address
Grandview Hospital
Robert F Henry, Inc
Alliance Physician Inc
Alliance Physician Inc
Alliance Physician Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
311

Additional practice sites

  • 4000 Miamisburg Centerville Rd, Miamisburg, OH
  • 3535 Southern Blvd, Kettering, OH

Registry record

Primary taxonomy
207P00000X
207P00000X
Licence states on file
OH
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2020-07-27

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Ohio