Individual
KELSEY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
118 MEDICAL DR, CARMEL, IN 46032-3323
(812) 241-9852
Mailing address
11210 BAYCREEK DR, INDIANAPOLIS, IN 46236-9104
(812) 241-9852
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06005782A
IN
Other
Enumeration date
08/18/2021
Last updated
08/18/2021
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