MEDICARE: LANE FAMILY CHIROPRACTIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	FL 0008563	FL

General Provider Information

NPI Number	:	1356519425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANE FAMILY CHIROPRACTIC

Provider Business Mailing Address
First Line	:	1307 W FLETCHER AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-3310
Country	:	US
Telephone Number	:	813-968-4293
Fax Number	:

Provider Business Practice Location Address
First Line	:	1307 W FLETCHER AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-3310
Country	:	US
Telephone Number	:	813-968-4293
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTIC PHYSICIAN
Name	:	DR. THOMAS MICHAEL LANE
Credential	:	D.C.
Telephone Number	:	813-968-4293

Provider Enumeration Date	:	02/12/2008
Last Update Date	:	02/12/2008

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Directions to “LANE FAMILY CHIROPRACTIC ” Practice Location

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