Individual
KODY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
801 BURR OAK DR, OCOEE, FL 34761-3134
(321) 947-7545
Mailing address
801 BURR OAK DR, OCOEE, FL 34761-3134
(321) 947-7545
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA105299
FL
Other
Enumeration date
08/13/2024
Last updated
08/13/2024
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