MEDICARE: SARAH B LANE ND

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	175F00000X	Naturopath	11	MT

General Provider Information

NPI Number	:	1770609802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH B LANE ND

Provider Business Mailing Address
First Line	:	3700 S RUSSELL ST
Second Line	:	SUITE 105
City	:	MISSOULA
State	:	MT
Zip	:	59801-8574
Country	:	US
Telephone Number	:	406-541-3040
Fax Number	:	406-541-3041

Provider Business Practice Location Address
First Line	:	3700 S RUSSELL ST
Second Line	:	SUITE 105
City	:	MISSOULA
State	:	MT
Zip	:	59801-8574
Country	:	US
Telephone Number	:	406-541-3040
Fax Number	:	406-541-3041

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	07/08/2007

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Directions to “ SARAH B LANE ND” Practice Location

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