Individual
BOBBY LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, RN
Contact information
Practice address
7832 ROYAL LN APT 112, DALLAS, TX 75230-3724
(214) 998-5085
Mailing address
7832 ROYAL LN APT 112, DALLAS, TX 75230-3724
(214) 998-5085
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
883861
TX
163WM1400X
Nurse Massage Therapist (NMT)
MT029279
TX
171400000X
Health & Wellness Coach
NA
—
225700000X
Massage Therapist
Primary
MT029279
TX
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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