Individual
MISS CECILIA ANN LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
170 ATHLETICS CENTER, STILLWATER, OK 74078-0001
(316) 648-8941
Mailing address
800 E HALL OF FAME AVE APT 1025, STILLWATER, OK 74075-6428
(316) 648-8941
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
989
OK
Other
Enumeration date
01/15/2019
Last updated
01/15/2019
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