Provider Demographics
NPI:1659084929
Name:LANG, OMIA LINETTE
Entity Type:Individual
Prefix:
First Name:OMIA
Middle Name:LINETTE
Last Name:LANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7584 OLD MADISON PIKE NW APT 307
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-4509
Mailing Address - Country:US
Mailing Address - Phone:312-343-0838
Mailing Address - Fax:
Practice Address - Street 1:7584 OLD MADISON PIKE NW APT 307
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-4509
Practice Address - Country:US
Practice Address - Phone:312-343-0838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer