Individual
BILLY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
AMAZON FULLFILLMENT CENTER TPA1, 3350 LAUREL RIDGE AVE,, RUSKIN, FL 33570
(866) 203-8361
Mailing address
2711 LAKEVILLE DR, TAMPA, FL 33618-1101
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL5353
FL
Other
Enumeration date
11/21/2019
Last updated
11/21/2019
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