Provider Demographics
NPI:1912507989
Name:SPIKER, LANE
Entity Type:Individual
Prefix:
First Name:LANE
Middle Name:
Last Name:SPIKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 SW 37TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-2590
Mailing Address - Country:US
Mailing Address - Phone:785-266-5850
Mailing Address - Fax:785-266-0021
Practice Address - Street 1:2117 SW 37TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-2590
Practice Address - Country:US
Practice Address - Phone:785-266-5850
Practice Address - Fax:785-266-0021
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-03722225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant