Individual
KENA XTAVIER LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3651 CELESTE OAKS DR, SARALAND, AL 36571-8819
(251) 442-4225
Mailing address
3651 CELESTE OAKS DR, SARALAND, AL 36571-8819
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S12738
AL
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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