Individual
MS. SUSANNE LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
471 PROSPECT ST, BROCKTON, MA 02301-2534
(508) 580-1544
(508) 580-1967
Mailing address
471 PROSPECT ST, BROCKTON, MA 02301-2534
(508) 580-1544
(508) 580-1967
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
NA
MA
Other
Enumeration date
02/21/2008
Last updated
02/21/2008
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