Provider Demographics
NPI:1699309559
Name:LANE, CHRISTOPHER ROBERT (PT)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ROBERT
Last Name:LANE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 LENOX PARK BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-5827
Mailing Address - Country:US
Mailing Address - Phone:404-261-8700
Mailing Address - Fax:
Practice Address - Street 1:1000 LENOX PARK BLVD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30319-5827
Practice Address - Country:US
Practice Address - Phone:404-261-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT013076225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist