Individual
MR. CONOR TIMOTHY LAURENCELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
5301 MCAULEY DR, YPSILANTI, MI 48197-1051
(734) 712-3456
Mailing address
1588 WEEPING WILLOW CT, YPSILANTI, MI 48198
(248) 225-5802
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010729
MI
Other
Enumeration date
08/09/2022
Last updated
08/09/2022
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