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Individual

ABBY M LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
2005 N. MISSOURI ST., SUITE D, MACON, MO 63552-0387
(660) 385-6540
(660) 385-6542
Mailing address
30251 LAUREL PL, MACON, MO 63552-3802
(660) 385-1374

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
112589
MO

Other

Enumeration date
03/21/2007
Last updated
07/24/2009
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