Individual
LORAN CALLIE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
6600 VAN AALST BLVD, FORT BENNING, GA 31905-5637
(762) 408-2273
Mailing address
1219 SHIPLEY DR, NICEVILLE, FL 32578-3956
(817) 734-6255
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT82615
TX
Other
Enumeration date
06/30/2015
Last updated
06/30/2015
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