Individual
DUSTIN LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
54 N 200 E, CEDAR CITY, UT 84720-2615
(435) 586-2515
Mailing address
4222 W 125 N, CEDAR CITY, UT 84720-8564
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/25/2011
Last updated
02/25/2011
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