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General NPI Number Information
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NPI Number | 1386519908
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Entity Type | Individual
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Provider Name | KATHY BURDICK LANE PT
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Gender | Female
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 407 LAURA LEE DR
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City | WHITE PINE
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State | TN
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Zip | 37890-3500
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Country | US
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Telephone | 865-327-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 4528 HORSESHOE TRL
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City | MORRISTOWN
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State | TN
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Zip | 37814-8030
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Country | US
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Telephone | 865-318-5304
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 992
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License Number State | TN
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