Individual
DAVINA YVONNE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14901 BOGLE DR STE 100, CHANTILLY, VA 20151-1736
(540) 931-4610
Mailing address
4415 HENDRICKS DR, WOODBRIDGE, VA 22193-5142
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305216730
VA
Other
Enumeration date
05/31/2024
Last updated
10/14/2024
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