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Individual
SANDRA B LANE
Active
Individual
SANDRA B LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC-004456-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012324490002
—
PA
01
—
60656880
STATE INDUSTRIAL ACCIDENT
PA
01
—
815631
PPO NUMBER B3
PA
Enumeration date
04/21/2006
Last updated
08/23/2013
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