SearchSouth Carolina390200000X

Jordan Lane

NPI 1811443997 · on the registry since 2016 · sole proprietor

Practice

Address
8747 Alexandria Dr
North Charleston, SC 29420
Phone
(843) 751-7449

Registry record

Primary taxonomy
390200000X
390200000X
Also registered as
2255A2300X
390200000X
Licence states on file
SC
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2016-08-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in South Carolina