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1104129139
JEFFERY DALE LANE
LUMBERTON, NC
NPI
1104129139
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: NC 176399)
Enumeration Date
2010-12-14
Last Update Date
2010-12-14
Business Address
-- JEFFERY DALE LANE CRNA
300 W 27TH ST
LUMBERTON, NC 28358-3075
Phone number: 910-671-5000
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Mailing Address
-- JEFFERY DALE LANE CRNA
5210 MCLEOD RD
LUMBERTON, NC 28358-8509
Phone number: 910-671-3671
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