Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Katherine M Lake, PT

Individual provider Physical Therapist · NPI 1700012168

Mary Katherine M Lake, PT is a Physical Therapist in Private Practice in Peterborough, New Hampshire. Qualified in 1995, 31 years ago. Practices with Healthpro Heritage Rehab and Fitness LLC, a 990-clinician group and accepts Medicare assignment. Licensed in New Hampshire.

Years since qualifying
31
Licensed in
NH
In the registry since
2009
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

458 Old Street Rd
Peterborough, NH 03458-1265
Phone: (603) 924-4635
Fax: (603) 924-4634
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2925 (NH)

Record details

NPI number1700012168
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorYes
NPI enumeratedMay 29, 2009
Last updated in NPPESMay 29, 2009

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Healthpro Heritage Rehab And Fitness Llc — 990 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Peterborough