Individual
JUSTIN ANTHONY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
304 WOODLAKE LN # 304, PONTIAC, MI 48340-1183
(313) 574-8845
Mailing address
304 WOODLAKE LN # 304, PONTIAC, MI 48340-1183
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
2012088
MI
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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