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General NPI Number Information
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NPI Number | 1376429282
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Entity Type | Individual
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Provider Name | REBECCA LAKE PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 389 MAIN ST
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City | HAVERHILL
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State | MA
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Zip | 01830-4061
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Country | US
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Telephone | 978-478-5050
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Fax |
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Provider Business Mailing Address
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Address Line | 18 ALLENCLAIR DR
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City | AMESBURY
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State | MA
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Zip | 01913-2204
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTL25895
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License Number State | MA
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