Organization
HANNELE LAINE, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACKIE ANDERSEN (OFFICE MANAGER)
(801) 355-9951
Entity
Organization
Contact information
Practice address
455 E SOUTH TEMPLE, STE 202, SLC, UT 84111-1350
(801) 355-9951
(801) 355-9968
Mailing address
455 E SOUTH TEMPLE, STE 202, SLC, UT 84111-1350
(801) 355-9951
(801) 355-9968
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
57672111205
UT
Other
Enumeration date
03/03/2011
Last updated
03/03/2011
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