Individual
MRS. BANEKA LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OWNER
Contact information
Practice address
202 KATHERINE DR, COLUMBIA, MS 39429-8747
(601) 441-3680
(601) 510-9991
Mailing address
419 COLUMBIA ST, BOGALUSA, LA 70427-4500
(601) 441-3680
(601) 510-9991
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
23859
LA
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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