Individual
VIVIAN LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2150 LEXINGTON RD STE G, RICHMOND, KY 40475-7924
(859) 333-8147
Mailing address
343 BURTON RD, NANCY, KY 42544-8546
(606) 636-4752
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R1459
KY
Other
Enumeration date
06/21/2011
Last updated
06/21/2011
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