Individual
CALLIE ANNE LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
8825 W 75TH ST, OVERLAND PARK, KS 66204-2206
(913) 648-6755
Mailing address
8634 BROME RD, DE SOTO, KS 66018-9304
(913) 850-0074
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-06771
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-06771
KANSAS STATE BOARD OF HEALING ARTS
KS
Enumeration date
07/07/2021
Last updated
07/07/2021
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