MITCHELL D LANE

SHREVEPORT, LA
NPI1750522868
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: TX  PA06014)
Enumeration Date2009-03-19
Last Update Date2023-05-24
Business Address
Mr. MITCHELL D LANE PA-C
510 E STONER AVE
SHREVEPORT, LA 71101-4243
Phone number: 318-221-8411
Mailing Address
Mr. MITCHELL D LANE PA-C
9514 BONNYDUNE DR
SHREVEPORT, LA 71106-7506
Phone number: 318-617-5047
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