Most Relevant Information
Provider Data
| NPI Number: | 1003500802 |
| Provider Name: | JEFF S LANE PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 000946 |
Most Important Dates
| Enumeration Date: | 06/05/2023 |
| Last Updated: | 06/05/2023 |
Provider Practice Location
67 CASINO DRIVE
SUITE 104
ANMORE
WV
26323
Practice Location Phone/Fax
| Phone: | 3046222684 |
| Fax: |
Provider Mailing Location
5320 GEORGETOWN RD
HORNER
WV
263729687
Provider Mailing Phone/Fax
| Phone: | 3045170271 |
| Fax: |