Individual
MICHAEL JEFFERY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATP
Contact information
Practice address
10632 ALCO AVE, UNIT 1, BATON ROUGE, LA 70816-4238
(866) 795-4825
(877) 723-6236
Mailing address
1622 BELLROSE DR, BATON ROUGE, LA 70815-5433
(504) 210-9293
(877) 723-6236
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
ATP 2652
IL
Other
Enumeration date
10/24/2012
Last updated
10/24/2012
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