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1194078360
MICHAEL JEFFERY LANE
BATON ROUGE, LA
NPI
1194078360
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
247200000X Technician, Other
(Licence: IL ATP 2652)
Enumeration Date
2012-10-24
Last Update Date
2012-10-24
Business Address
-- MICHAEL JEFFERY LANE ATP
10632 ALCO AVE UNIT 1
BATON ROUGE, LA 70816-4238
Phone number: 866-795-4825
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Mailing Address
-- MICHAEL JEFFERY LANE ATP
1622 BELLROSE DR
BATON ROUGE, LA 70815-5433
Phone number: 504-210-9293
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