Individual
EVAN LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
622 ROSE AVE, BARNESVILLE, GA 30204-1541
(770) 358-4600
Mailing address
622 ROSE AVE, BARNESVILLE, GA 30204-1541
(770) 358-4600
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
029285
GA
Other
Enumeration date
11/26/2020
Last updated
11/26/2020
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