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1114950045
DAVID THOMAS LANE
MYRTLE BEACH, SC
NPI
1114950045
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: SC 10663)
Enumeration Date
2006-07-07
Last Update Date
2024-12-19
Business Address
DAVID THOMAS LANE LISW-CP
470 ROSE FOUNTAIN DR
MYRTLE BEACH, SC 29579-4511
Phone number: 843-457-1775
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Mailing Address
DAVID THOMAS LANE LISW-CP
470 ROSE FOUNTAIN DR
MYRTLE BEACH, SC 29579-4511
Phone number: 843-457-1775
Copy
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