Individual
THOMAS LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2071 MIDWAY DR, TWINSBURG, OH 44087-1933
(330) 425-7978
Mailing address
2071 MIDWAY DR, TWINSBURG, OH 44087-1933
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497081905
—
OH
Enumeration date
11/18/2016
Last updated
11/18/2016
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