Individual
JAYME LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
200 W 4TH ST, OAKTOWN, IN 47561-8081
(812) 745-2360
Mailing address
168 N JACKSON RD, VINCENNES, IN 47591-8760
(812) 890-6593
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003909A
IN
Other
Enumeration date
02/12/2017
Last updated
02/12/2017
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