Provider Demographics
NPI:1659634905
Name:LANG, JANENE (LAC)
Entity type:Individual
Prefix:
First Name:JANENE
Middle Name:
Last Name:LANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8652 S MARKET PLACE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-3524
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8652 S MARKET PLACE
Practice Address - Street 2:SUITE 2
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-3524
Practice Address - Country:US
Practice Address - Phone:920-318-1352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist