Individual
BRADLEY ALLEN LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
114 NATIONWIDE DR, LYNCHBURG, VA 24502-4271
(434) 239-7890
Mailing address
114 NATIONWIDE DR, LYNCHBURG, VA 24502-4271
(434) 239-7890
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0102207039
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Enumeration date
03/22/2018
Last updated
04/27/2022
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