JILL M LANE LLC
Optometry at Main St, Grangeville, ID

License number
Idaho ODP-100095
Category
Optometry
Type
Optometrist
Owner
Name: DR. JILL MARIE LANE O.D.
Title: PRESIDENT/PHYSICIAN
Phone: (208) 983-3732
Address
Address
405 E Main St, Grangeville, ID 83530
National Provider ID: 1902078785
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about JILL M LANE LLC at bizstanding.com

JILL M. LANE LLC

Grangeville, ID

Status:
Inactive
Industry:
Business Services at Non-Commercial Site, Optometrist's Office
Registration:
Aug 7, 2006
Inactive since:
Nov 10, 2010
Addresses:
158 E Main St, Grangeville, ID 83530 (Physical)
210 SE 5 St, Grangeville, ID 83530
State ID:
W53315
Business type:
LIMITED LIABILITY COMPANY
Owners:
Jill M. Dekaye (Medical Doctor, President, Principal),Jill Marie Lane (Medical Doctor),Lane Jill Owner, inactive
Agent:
Jill M Lane,158 E Main St, Grangeville, ID 83530 (Physical)

Optometry licenses in Idaho

Other Doctors licenses in Idaho