Delisa Lane, LMT

NPI #1457967994 in Dumfries, Virginia

Provider Information

NPI Number: 1457967994
Entity Type: Individual
Name: Delisa Lane, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Sep 21, 2020
Last Updated: Sep 21, 2020

Practice Location

Address: 4000 MIDDLETON LOOP APT 203
City: Dumfries
State: Virginia
ZIP Code: 22025-2113
Phone: (540) 361-8332

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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