Individual
MR. LANE BREDESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPHT
Contact information
Practice address
422 MAIN AVE, OAKES, ND 58474-1637
(701) 742-3315
Mailing address
214 MAIN AVE, OAKES, ND 58474-1150
(701) 742-3315
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
RPHT1397
ND
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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