Individual
MR. W. D. PETER LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT CNMT
Contact information
Practice address
8005 PENNSYLVANIA CIR NE, ALBUQUERQUE, NM 87110-7810
(505) 248-0698
Mailing address
78 KIVA PL, SANDIA PARK, NM 87047-8510
(505) 688-6732
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1636
NM
Other
Enumeration date
06/15/2007
Last updated
07/08/2007
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