Individual
MR. LANE ENTREKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
13762 S 3160 W, RIVERTON, UT 84065-5901
(801) 243-5544
Mailing address
13762 S 3160 W, RIVERTON, UT 84065-5901
(801) 243-5544
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP 11232
CA
Other
Enumeration date
09/16/2007
Last updated
07/28/2010
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