Individual
JEANETTE L LAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
685 PEACHWOOD DR, DELAND, FL 32720-0804
(386) 736-3463
(386) 736-3492
Mailing address
12109 COUNTY ROAD 103, OXFORD, FL 34484-2951
(352) 205-8981
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104131
FL
Other
Enumeration date
07/25/2006
Last updated
03/16/2021
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