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1003500802
JEFF S LANE
ANMORE, WV
NPI
1003500802
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: WV 000946)
Enumeration Date
2023-06-05
Last Update Date
2023-06-05
Business Address
Mr. JEFF S LANE PTA
67 CASINO DRIVE SUITE 104
ANMORE, WV 26323
Phone number: 304-622-2684
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Mailing Address
Mr. JEFF S LANE PTA
5320 GEORGETOWN RD
HORNER, WV 26372-9687
Phone number: 304-517-0271
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