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General NPI Number Information
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NPI Number | 1164610747
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Entity Type | Organization
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Legal Business Name | LANEY ENTERPRISES, INC
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 804 KELLER PKWY
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City | KELLER
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State | TX
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Zip | 76248-2405
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Country | US
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Telephone | 817-379-9324
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Fax | 817-431-5044
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Provider Business Mailing Address
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Address Line | 804 KELLER PKWY
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City | KELLER
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State | TX
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Zip | 76248-2405
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Country | US
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Telephone | 817-379-9324
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Fax | 817-431-5044
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Authorized Official
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Title or Position | PRESIDENT
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Name | DARYL GENE LANEY
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Credential | D.C.
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Telephone | 817-379-9324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1174526
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License Number State | TX
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