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1003622234
JUSTIN ANTHONY LANE
PONTIAC, MI
NPI
1003622234
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207PE0004X Emergency Medicine, Emergency Medical Services
(Licence: MI 2012088)
Enumeration Date
2024-12-03
Last Update Date
2024-12-03
Business Address
JUSTIN ANTHONY LANE
304 WOODLAKE LN # 304
PONTIAC, MI 48340-1183
Phone number: 313-574-8845
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Mailing Address
JUSTIN ANTHONY LANE
304 WOODLAKE LN # 304
PONTIAC, MI 48340-1183
Phone number:
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