Individual
LANE JEREMIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
200 SOUTHWEST BLVD, KANSAS CITY, MO 64108-2019
(816) 842-1146
Mailing address
2006 BROOKHAVEN DR, ALMA, AR 72921-5012
(479) 739-4485
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5015
AR
225100000X
Physical Therapist
CP014856T
MO
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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