Individual
DORIS M LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
RT S 209 & 115, BRODHEADSVILLE, PA 18322
(570) 992-2373
(570) 992-2617
Mailing address
104 SUNNYSIDE CT, SAYLORSBURG, PA 18353-9245
(570) 629-4128
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
7274
OR
183500000X
Pharmacist
Primary
RP033974R
PA
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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