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1902113798
ANITA ELLIOTT LANE
FORT WORTH, TX
NPI
1902113798
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: TX 100842)
Enumeration Date
2010-09-01
Last Update Date
2010-10-19
Business Address
ANITA ELLIOTT LANE OTR
3840 HULEN ST
FORT WORTH, TX 76107-7277
Phone number: 817-569-4396
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Mailing Address
ANITA ELLIOTT LANE OTR
PO BOX 2603
FORT WORTH, TX 76113-2603
Phone number: 817-569-4396
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