Individual
ALAN D LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
386 E PINE ST, BOURBON, MO 65441-7506
(573) 732-4418
(573) 732-3640
Mailing address
599 HIGHWAY DD APT 6, CUBA, MO 65454
(573) 415-6081
(573) 732-3640
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2011005721
MO
Other
Enumeration date
03/05/2014
Last updated
03/05/2014
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