Individual
LAVICA LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
814 DALWORTH ST, GRAND PRAIRIE, TX 75050-5545
(972) 263-0299
(972) 642-4171
Mailing address
814 DALWORTH ST, GRAND PRAIRIE, TX 75050-5545
(972) 263-0299
(972) 642-4171
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
99284
TX
Other
Enumeration date
01/16/2017
Last updated
01/16/2017
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