MEDICARE: KADYN ASHLEY LANE PT, DPT

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1952268740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KADYN ASHLEY LANE PT, DPT

Provider Business Mailing Address
First Line	:	40131 N THUNDER HILLS CT
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85086-2993
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2302 N 15TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85007-1201
Country	:	US
Telephone Number	:	602-362-6223
Fax Number	:

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

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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