Individual
SHANNON NICOLE KAYE ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
15520 19 MILE RD STE 450, CLINTON TWP, MI 48038-6332
(586) 416-2000
(586) 416-2013
Mailing address
33900 HARPER AVE STE 104, CLINTON TWP, MI 48035-4258
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601003228
MI
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/19/2026
Last updated
05/07/2026
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