Individual
KORTNEY R LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5301 GROVE HILL RD, TEMPLE TERRACE, FL 33617-7127
(727) 417-6738
Mailing address
5301 GROVE HILL RD, TEMPLE TERRACE, FL 33617-7127
(727) 417-6738
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
92553
FL
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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