Mark Jefferson Lance

NPI #1477820843 in Slc, Utah

Provider Information

NPI Number: 1477820843
Entity Type: Individual
Name: Mark Jefferson Lance
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Case Manager/Care Coordinator
Enumeration Date: Nov 29, 2011
Last Updated: Nov 29, 2011

Practice Location

Address: 650 KOMAS DR
Address 2: 200
City: Slc
State: Utah
ZIP Code: 84108-1215
Phone: (801) 587-3359

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X	Primary

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