Individual
JENYCE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1030 DELTA BLVD, ATLANTA, GA 30354-1989
(404) 773-7480
Mailing address
1269 BROOKSIDE RD, PISCATAWAY, NJ 08854-5140
(732) 266-1564
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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