Lake, Olivia

Lake, Olivia is an individual health care provider with primary practice located at 111 Boland St # 210 , Fort Worth TX 76107-1263. She recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Specialist/Technologist, Other, which is considered as her primary health care specialty. Lake, Olivia can be contacted via phone (817) 529-8485.

Contact Information

Primary practice address
111 Boland St # 210 Fort Worth TX 76107-1263
Phone: (817) 529-8485
Fax: (469) 453-5075
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Specialist/Technologist, Other 246Z00000X

Profile Details

NPI number 1073289955
LBN Legal business name Lake, Olivia
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2021
Last updated Aug 19th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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