Individual
AUDRY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5265 W C ROGERS BLVD, SKIATOOK, OK 74056
(539) 589-0005
Mailing address
8748 N MINGO RD APT 214, OWASSO, OK 74055-5067
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5934
OK
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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