MICHAEL JAMES LANE

SPRINGFIELD, MO
NPI1962042358
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist Athletic Trainer
(Licence: MO  2013023199)
Enumeration Date2020-01-13
Last Update Date2020-01-13
Business Address
MICHAEL JAMES LANE ATC
4331 S FREMONT AVE
SPRINGFIELD, MO 65804-7328
Phone number: 417-820-5010
Mailing Address
MICHAEL JAMES LANE ATC
3651 S SUNRISE AVE
SPRINGFIELD, MO 65807-0986
Phone number: 636-293-4673
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