Provider Demographics
NPI:1851051270
Name:LANE, YUKO (LMT)
Entity Type:Individual
Prefix:MRS
First Name:YUKO
Middle Name:
Last Name:LANE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 KEMPSVILLE RD STE C
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-1406
Mailing Address - Country:US
Mailing Address - Phone:757-410-5322
Mailing Address - Fax:
Practice Address - Street 1:1421 KEMPSVILLE RD STE C
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1406
Practice Address - Country:US
Practice Address - Phone:757-410-5322
Practice Address - Fax:757-548-0670
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0019016628OtherCOMMONWEALTH OF VIRGINIA LICENSE