SearchTexas225700000X

Perry Lake, LMT/CMT

NPI 1790443398 · on the registry since 2021 · sole proprietor

Practice

Address
1101 S David St
San Angelo, TX 76903
Phone
(208) 241-1632

Registry record

Primary taxonomy
225700000X
225700000X
Also registered as
225700000X
225700000X
Licence states on file
UT, ID, TX
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-12-01

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 Texas