Individual
STACY ALEKS LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1044 BELMONT AVE, YOUNGSTOWN, OH 44504-1006
(330) 480-2616
Mailing address
4102 CREDE DR, CHARLESTON, WV 25302-4710
(304) 716-1696
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
58.032408
OH
Other
Enumeration date
04/26/2021
Last updated
06/30/2021
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