Individual
JOHN LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
615 N 19TH ST, FORT SMITH, AR 72901-3319
(479) 785-4083
(479) 668-2058
Mailing address
615 N 19TH ST, FORT SMITH, AR 72901-3319
(479) 785-4083
(479) 668-2058
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
AR
Other
Enumeration date
12/19/2013
Last updated
12/19/2013
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