Individual
JACOB LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
940 N 400 E STE 204, NORTH SALT LAKE, UT 84054-1985
(903) 922-9156
Mailing address
940 N 400 E STE 204, NORTH SALT LAKE, UT 84054-1985
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
13606131-1202
UT
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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