Individual
EMILY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
204 N STACY AVE, GANS, OK 74936-0070
(918) 775-2236
Mailing address
PO BOX 70, GANS, OK 74936-0070
(918) 775-2236
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
04/04/2016
Last updated
04/04/2016
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