Provider Demographics
NPI:1548484520
Name:LANE, BRITTANI (OTRL)
Entity type:Individual
Prefix:MISS
First Name:BRITTANI
Middle Name:
Last Name:LANE
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:427 FAIRGROUNDS RD
Mailing Address - Street 2:UNIT 1
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4355
Mailing Address - Country:US
Mailing Address - Phone:423-787-5063
Mailing Address - Fax:423-787-5017
Practice Address - Street 1:1420 TUSCULUM BLVD
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4279
Practice Address - Country:US
Practice Address - Phone:423-787-5063
Practice Address - Fax:423-787-5017
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3632225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist