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Individual

DR. JEREMY HEATH LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
318 JACKSON AVE S, RUSSELLVILLE, AL 35653-2207
(256) 332-8550
(256) 332-8081
Mailing address
318 JACKSON AVE S, RUSSELLVILLE, AL 35653-2207
(256) 332-8550
(256) 332-8081

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15154
AL

Other

Enumeration date
04/09/2010
Last updated
04/09/2010
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