Individual
MELAINA MARIE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
1775 CANDY LN, CARBONDALE, IL 62902-1022
(217) 549-3301
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.004808
IL
Other
Enumeration date
05/09/2011
Last updated
05/09/2011
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