LYDIA LANE JACKSON

MONTGOMERY, AL
NPI1487642161
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: AL  PA198)
Enumeration Date2005-10-07
Last Update Date2007-07-13
Business Address
-- LYDIA LANE JACKSON PA C
215 PERRY HILL RD
MONTGOMERY, AL 36109-3725
Phone number: 334-272-4670
Mailing Address
-- LYDIA LANE JACKSON PA C
7028 CROSS BEND CT
MONTGOMERY, AL 36117-2445
Phone number: 334-213-6441
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