Individual
JESSICA ELIZABETH LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
751 W 2ND ST STE 200, PERU, IN 46970-1385
(765) 919-4444
Mailing address
519 YORK RD, GALVESTON, IN 46932-9775
(765) 480-8161
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31007603A
IN
225X00000X
Occupational Therapist
32003154A
IN
Other
Enumeration date
03/23/2017
Last updated
09/01/2022
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