Provider Demographics
NPI:1861899874
Name:LANN, INA
Entity type:Individual
Prefix:
First Name:INA
Middle Name:
Last Name:LANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 SAILOR CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:AL
Mailing Address - Zip Code:35592-4841
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:241 ROBERT K WILSON DRIVE
Practice Address - Street 2:PICKENS COUNTY MEDICAL CENTER
Practice Address - City:CARROLLTON
Practice Address - State:AL
Practice Address - Zip Code:35447
Practice Address - Country:US
Practice Address - Phone:205-367-2468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTA7351225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant