Individual
MS. JUDITH B LANE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2448 MERRITT CREEK LOOP, COEUR D'ALENE, ID 83814-4953
(208) 664-2901
(208) 667-9266
Mailing address
2448 MERRITT CREEK LOOP, COEUR D'ALENE, ID 83814-4953
(208) 664-2901
(208) 667-9266
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-681
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010143554
REGENCE BLUE SHIELD
ID
01
—
0265507
STATE OF WA LABOR & INDUS
ID
01
—
28169
GROUP HEALTH
ID
01
—
T5006
BLUE CROSS OF IDAHO
ID
Enumeration date
12/08/2005
Last updated
07/08/2007
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