Individual
DONNA MICHELLE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1111 CHURCH AVE, JASPER, IN 47546-3761
(812) 634-7750
Mailing address
1111 CHURCH AVE, JASPER, IN 47546-3761
(812) 634-7750
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05003328A
IN
Other
Enumeration date
04/02/2008
Last updated
04/02/2008
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