Individual
LANE RAY ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
500 BOMBER BLVD, MOUNTAIN HOME, AR 72653-4628
(870) 656-9289
Mailing address
500 BOMBER BLVD, MOUNTAIN HOME, AR 72653-4628
(870) 656-9289
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
AR
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
08/30/2018
Last updated
10/04/2022
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