Individual
SARA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
698 HOWARD ST, SPARTANBURG, SC 29303-2964
(864) 596-8491
Mailing address
PO BOX 970, SPARTANBURG, SC 29304-0970
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
3040
SC
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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