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General NPI Number Information
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NPI Number | 1861427916
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Entity Type | Individual
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Provider Name | CHRISTIAN HORTON LANE RTR,RCS
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Gender | Female
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 136 MEMORY PLZ
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City | WHITEVILLE
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State | NC
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Zip | 28472-2640
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Country | US
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Telephone | 910-654-4789
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Fax | 910-654-6939
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Provider Business Mailing Address
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Address Line | PO BOX 434
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City | CHADBOURN
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State | NC
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Zip | 28431-0434
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Country | US
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Telephone | 910-914-6154
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Fax | 910-914-6156
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 112625
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License Number State | NC
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