JAKE LANE

MARIETTA, GA
NPI1417506304
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367H00000X Anesthesiologist Assistant
Enumeration Date2019-09-04
Last Update Date2019-09-24
Business Address
JAKE LANE
677 CHURCH ST NE
MARIETTA, GA 30060-1101
Phone number: 770-794-0477
Mailing Address
JAKE LANE
531 ROSELANE ST NW STE 830
MARIETTA, GA 30060-6979
Phone number: 770-794-0477