Individual
TAMMIE R LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1105 ALEXIS CT, MANSFIELD, TX 76063-3343
(817) 770-6540
Mailing address
1105 ALEXIS CT STE 101, MANSFIELD, TX 76063-3344
(817) 770-6540
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT107846
TX
Other
Enumeration date
08/12/2011
Last updated
11/11/2013
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