Provider Demographics
NPI:1801406491
Name:LANE, CHRIS YUN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:YUN
Last Name:LANE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16202 SPRING MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9071
Mailing Address - Country:US
Mailing Address - Phone:910-729-8314
Mailing Address - Fax:
Practice Address - Street 1:115 OAKDALE DR UNIT 8
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-9080
Practice Address - Country:US
Practice Address - Phone:919-732-6600
Practice Address - Fax:919-732-2779
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19410225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist