Individual
ANTHONY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
4415 W 36 1/2 ST, ST LOUIS PARK, MN 55416-4854
(952) 927-9717
(952) 927-7687
Mailing address
618 GRIFFIN ST, CARVER, MN 55315-9308
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103927
MN
Other
Enumeration date
05/06/2013
Last updated
05/06/2013
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