Individual
STEPHANIE LYNN LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 816-7224
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 816-7224
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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