| NPI | 1093088320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW MILLER LANE Doctor/Co Owner 913-745-4064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X |
| Additional Taxonomies | 111NR0400X |
| 225100000X Physical Therapist | |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2022-07-21 |