Provider Demographics
NPI:1831587229
Name:CATLETT, LANE (ATC, VATL)
Entity type:Individual
Prefix:
First Name:LANE
Middle Name:
Last Name:CATLETT
Suffix:
Gender:M
Credentials:ATC, VATL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19039 BULL CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:RUTHER GLEN
Mailing Address - State:VA
Mailing Address - Zip Code:22546-3028
Mailing Address - Country:US
Mailing Address - Phone:540-846-1303
Mailing Address - Fax:
Practice Address - Street 1:19039 BULL CHURCH RD
Practice Address - Street 2:
Practice Address - City:RUTHER GLEN
Practice Address - State:VA
Practice Address - Zip Code:22546-3028
Practice Address - Country:US
Practice Address - Phone:540-846-1303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260019192255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer