Individual
DAVID J LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AU.D., CCC-A
Contact information
Practice address
4117 S WATER TOWER PL, SUITE C, MOUNT VERNON, IL 62864-6293
(618) 242-0672
(618) 242-0862
Mailing address
4117 S WATER TOWER PL, SUITE C, MOUNT VERNON, IL 62864-6293
(618) 242-0672
(618) 242-0862
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147-000854
IL
Other
Enumeration date
05/11/2006
Last updated
08/30/2010
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