Individual
MR. JEFF S LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
67 CASINO DRIVE, SUITE 104, ANMORE, WV 26323
(304) 622-2684
Mailing address
5320 GEORGETOWN RD, HORNER, WV 26372-9687
(304) 517-0271
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000946
WV
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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