Individual
GREGORY LINDSEY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS PT
Contact information
Practice address
516 MONTGOMERY ST, DECORAH, IA 52101-2720
(563) 382-4770
(563) 382-4785
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02348
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0182790
—
IA
01
—
44396
BLUE CROSS OF IOWA
IA
01
—
8B773LA
BLUE CROSS OF MINNESOTA
MN
Enumeration date
08/09/2005
Last updated
04/04/2018
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