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Individual

MR. JOHN EDWARD LANE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
21 BURNSIDE STREET, LANCASTER, NH 03584-3241
(603) 381-0101
(603) 788-3720
Mailing address
21 BURNSIDE STREET, LANCASTER, NH 03584-3241
(603) 381-0101
(603) 788-3720

Taxonomy

Speciality
Code
Description
License number
State
225XH1300X
Human Factors Occupational Therapist
Primary
0405
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11446001
CAQH ID
NH
Enumeration date
11/27/2006
Last updated
07/09/2007
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