MEDICARE: PATRICIA J LANE PT

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	812	MT
2	2251S0007X	Sports Physical Therapist	812	MT
3	2251X0800X	Orthopedic Physical Therapist	812	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578546271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA J LANE PT

Provider Business Mailing Address
First Line	:	400 35TH AVE NE
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-4207
Country	:	US
Telephone Number	:	406-750-8538
Fax Number	:

Provider Business Practice Location Address
First Line	:	721 CENTRAL AVE STE 210
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59401-3770
Country	:	US
Telephone Number	:	406-750-8538
Fax Number	:

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

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	05/24/2023

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Directions to “ PATRICIA J LANE PT” Practice Location

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