Individual
ALAN LANE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1710 HARBOR DR, CLEARWATER, FL 33755-1825
(727) 643-8050
Mailing address
1710 HARBOR DR, CLEARWATER, FL 33755-1825
(727) 643-8050
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
6906897
FL
Other
Enumeration date
04/01/2017
Last updated
04/01/2017
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