Individual
DANE JACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1450 HIGHLAND AVE, EUSTIS, FL 32726-5738
(352) 434-5158
Mailing address
1450 HIGHLAND AVE, EUSTIS, FL 32726-5738
(352) 434-5158
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
02/29/2024
Last updated
02/29/2024
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