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Individual

MRS. BRYONY MICHELLE LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1600 7TH AVE S, PT/OT PARK PLACE, 3RD FLOOR, BIRMINGHAM, AL 35233-1711
(205) 939-6289
(205) 558-2077
Mailing address
1600 7TH AVE S, PT/OT PARK PLACE, 3RD FLOOR, BIRMINGHAM, AL 35233-1711
(205) 939-6289
(205) 558-2077

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2443
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
890012130
AL
Enumeration date
03/20/2006
Last updated
09/15/2009
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