JORDAN LANE

CHARLESTON, SC
NPI1619224003
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: SC  1798)
Enumeration Date2012-08-06
Last Update Date2013-10-24
Business Address
-- JORDAN LANE
171 ASHLEY AVE
CHARLESTON, SC 29425-8908
Phone number: 843-792-1414
Mailing Address
-- JORDAN LANE
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200
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