Individual
KEELY SHAE LANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1397 S COLLEGE ST, WINCHESTER, TN 37398-2414
(931) 962-3225
(931) 962-3103
Mailing address
PO BOX 4, WINCHESTER, TN 37398-0004
(931) 962-3225
(931) 962-3103
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5213
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5213
TN DEPT OF HEALTH
TN
Enumeration date
05/31/2012
Last updated
05/31/2012
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