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Individual

JUSTIN JAMES LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
881 NW 99TH AVE, PEMBROKE PINES, FL 33024-6162
(954) 437-8099
Mailing address
938 KOKOMO KEY LN, DELRAY BEACH, FL 33483-6031

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28115
FL

Other

Enumeration date
12/21/2017
Last updated
12/21/2017
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