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1962042358
MICHAEL JAMES LANE
SPRINGFIELD, MO
NPI
1962042358
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO 2013023199)
Enumeration Date
2020-01-13
Last Update Date
2020-01-13
Business Address
MICHAEL JAMES LANE ATC
4331 S FREMONT AVE
SPRINGFIELD, MO 65804-7328
Phone number: 417-820-5010
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Mailing Address
MICHAEL JAMES LANE ATC
3651 S SUNRISE AVE
SPRINGFIELD, MO 65807-0986
Phone number: 636-293-4673
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