Individual
KASSIDY ANN LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2724 SOQUEL AVE, SANTA CRUZ, CA 95062-1433
(831) 475-2565
Mailing address
2724 SOQUEL AVE, SANTA CRUZ, CA 95062-1433
(831) 475-2565
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
302232
CA
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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