NPI 1215759758

James Sebastian Lane

Practitioner Athletic Trainer Superior, WI

Practice location

Address: 1311 E 5th St, Superior, WI 54880-3305
Phone: (715) 817-5811

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

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Registry record

NPI: 1215759758
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Oct 2024
Record last updated: 28 Oct 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.