Individual
JUSTIN LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
2201 N BROADWELL AVE, GRAND ISLAND, NE 68803-2153
(308) 382-3660
Mailing address
3625 HIDDEN POINTE DR, GRAND ISLAND, NE 68803-2265
(402) 274-8262
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14910
NE
Other
Enumeration date
09/02/2015
Last updated
09/02/2015
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