Jill M Lane LLC

NPI #1902078785 in Grangeville, Idaho

Provider Information

NPI Number
1902078785
Entity Type
Organization
Organization Name
Jill M Lane LLC
Primary Specialty
Optometrist
Enumeration Date
Apr 1, 2008
Last Updated
Jan 12, 2017

Practice Location

Address
405 E MAIN ST
State
Idaho
ZIP Code
83530-2239
Phone
(208) 983-3732

Authorized Official

Name
DR. JILL MARIE LANE, O.D.
Title
PRESIDENT/PHYSICIAN
Phone
(208) 983-3732

Specialties & Taxonomy Codes

Specialty
Optometrist

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