Individual
DELLA J LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1140 N UPPER GOLD RD, DEWEY, AZ 86327-7392
(928) 308-0383
Mailing address
1140 N UPPER GOLD RD, DEWEY, AZ 86327-7392
(928) 308-0383
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/30/2007
Last updated
11/30/2007
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