Individual
LAURENCE B LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNFA
Contact information
Practice address
132 SUNRISE CT, FESTUS, MO 63028
(636) 933-2147
(636) 933-3908
Mailing address
132 SUNRISE CT, FESTUS, MO 63028
(636) 933-2147
(636) 933-3908
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
069722
MO
Other
Enumeration date
11/27/2006
Last updated
07/08/2007
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