CANDACE LANE

MACON, GA
NPI1467843854
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225XP0200X Occupational Therapist, Pediatrics
(Licence: GA  OT005726)
Additional Taxonomies225X00000X Occupational Therapist
(Licence: GA  OT005726)
Enumeration Date2015-02-07
Last Update Date2015-02-07
Business Address
-- CANDACE LANE OT
1014 FORSYTH ST
MACON, GA 31201-2051
Phone number: 478-633-6748
Mailing Address
-- CANDACE LANE OT
2490 RIVERSIDE DR STE B
MACON, GA 31204-1787
Phone number: