Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 015200-1 | NY |
NPI | 1063614386 |
---|---|
Provider Name | Dr. Lane L. Duger |
First Address | Auburn, NY 13021-4525 |
Second Address | Auburn, NY 13021-4525 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 08/07/2007 |