Provider Demographics
NPI:1043445604
Name:LANE, KARRI MOUREEN (LCMT)
Entity type:Individual
Prefix:MS
First Name:KARRI
Middle Name:MOUREEN
Last Name:LANE
Suffix:
Gender:F
Credentials:LCMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 5TH ST NW
Mailing Address - Street 2:SUITE D
Mailing Address - City:ELK RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:55330-1917
Mailing Address - Country:US
Mailing Address - Phone:763-370-3383
Mailing Address - Fax:
Practice Address - Street 1:200 5TH ST NW
Practice Address - Street 2:SUITE D
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-1917
Practice Address - Country:US
Practice Address - Phone:763-370-3383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist