Individual
COURTENEY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3641 MEMORIAL BLVD, KINGSPORT, TN 37664-3422
(423) 246-2411
Mailing address
3641 MEMORIAL BLVD, KINGSPORT, TN 37664-3422
(423) 747-1275
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3853
TN
Other
Enumeration date
02/22/2019
Last updated
02/22/2019
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