JORDAN LANE

NORTH CHARLESTON, SC
NPI1811443997
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Additional Taxonomies2255A2300X Specialist/Technologist, Athletic Trainer
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2016-08-29
Last Update Date2016-08-29
Business Address
Mr. JORDAN LANE
8747 ALEXANDRIA DR
NORTH CHARLESTON, SC 29420-7815
Phone number: 843-751-7449
Mailing Address
Mr. JORDAN LANE
8747 ALEXANDRIA DR
NORTH CHARLESTON, SC 29420-7815
Phone number: 843-751-7449