Individual
MELANIE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29 PARK PL APT 1402, HATTIESBURG, MS 39402-5902
(318) 469-3285
Mailing address
29 PARK PL APT 1402, HATTIESBURG, MS 39402-5902
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
009105465
LA
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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