Individual
LANE EVAN EDMONDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
420 RAILROAD ST, ELIZABETHTON, TN 37643-2504
(423) 297-1813
Mailing address
865 WOODMONT RD, JONESBOROUGH, TN 37659-3766
(423) 491-3939
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9138
TN
Other
Enumeration date
06/12/2026
Last updated
06/12/2026
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