Provider Demographics
NPI:1659356756
Name:LANE, TONI (DC)
Entity Type:Individual
Prefix:DR
First Name:TONI
Middle Name:
Last Name:LANE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 N JASMINE AVE
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-5241
Mailing Address - Country:US
Mailing Address - Phone:636-734-0225
Mailing Address - Fax:
Practice Address - Street 1:210 S PINELLAS AVE STE 152
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-3613
Practice Address - Country:US
Practice Address - Phone:636-734-0225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-12
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13588111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO143772OtherGHP
MO122330OtherBLUE CROSS/BLUE SHIELD
MO336547OtherHEALTHLINK
MOU68147Medicare UPIN