MR. Jeremy Lane JR., P.A.-C.
NPI #1144205220 in St Louis Park, Minnesota
Provider Information
- NPI Number
- 1144205220
- Entity Type
- Individual
- Name
- MR. Jeremy Lane JR., P.A.-C.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Surgical
- Credential
- P.A.-C.
- Enumeration Date
- Dec 12, 2005
- Last Updated
- Mar 29, 2019
Practice Location
- Address
- 3931 LOUISIANA AVE S
- City
- St Louis Park
- State
- Minnesota
- ZIP Code
- 55426-5000
- Phone
- (952) 993-3230
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Surgical — Surgical |
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