| Doctor Name: | ELIZABETH LANE |
| NPI Number: | 1205298569 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | PT025116 |
| Business Practice Address: | 790 Remington Blvd Bolingbrook, IL - 604404909 |
| Business Phone Number: | 6302962223 |
| Business Fax Number: | 6307599510 |
| Mailing Address: | 4304 5th Street Hwy, Unit 4 TEMPLE |
| State: | PA |
| Postal Code: | 195601740 |
| Phone Number: | 4842202912 |
| Fax Number: | 6109292472 |
| NPI Enumeration Date: | 03/25/2016 |
| NPI Last Update Date: | 04/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT025116 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |