Provider Demographics
NPI:1427284538
Name:LANE, SARAH A (CO)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:LANE
Suffix:
Gender:F
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2807
Mailing Address - Country:US
Mailing Address - Phone:540-667-3631
Mailing Address - Fax:
Practice Address - Street 1:1726 AMHERST ST STE 600
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2807
Practice Address - Country:US
Practice Address - Phone:540-667-3631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO-2397222Z00000X
222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
6296160001Medicare NSC