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MR. JEFFREY FULTON LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
1303 JAMESTOWN RD, WILLIAMSBURG, VA 23185-3333
(757) 220-1355
Mailing address
6544 CREEK RD, HAYES, VA 23072-3218
(804) 642-6354

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202005254
VA

Other

Enumeration date
05/08/2011
Last updated
05/08/2011
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