Individual
JESSICA MICHELLE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2441 S HIGHWAY 27, SOMERSET, KY 42501-2935
(606) 677-4068
Mailing address
2441 S HIGHWAY 27, SOMERSET, KY 42501-2935
(606) 677-4068
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A02740
KY
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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