Individual
EDWARD KENDRICK LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4500 E 9TH AVE STE 450, DENVER, CO 80220-3933
(303) 394-9355
(303) 388-8564
Mailing address
4900 S MONACO ST, #210, DENVER, CO 80237-3486
(303) 394-9355
(303) 388-8564
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3034
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35257229
—
CO
Enumeration date
10/05/2010
Last updated
01/27/2022
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