Individual
JULIA ELIZABETH LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22125 RICHMOND CT, MACOMB, MI 48042-1749
(586) 256-1414
Mailing address
22125 RICHMOND CT, MACOMB, MI 48042-1749
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601012710
MI
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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