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1013541341
KIRT LANE
LONGVIEW, WA
NPI
1013541341
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2020-02-25
Last Update Date
2023-09-18
Business Address
KIRT LANE CPC
1408 12TH AVENUE
LONGVIEW, WA 98632-3822
Phone number: 360-998-3050
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Mailing Address
KIRT LANE CPC
PO BOX 2394
LONGVIEW, WA 98632
Phone number: 360-200-5419
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