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Individual

SHAINA MARIE LANE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.ED., ATC

Contact information

Practice address
GRAND VALLEY STATE UNIVERSITY, 1 CAMPUS DR., 83 FH, ALLENDALE, MI 49401
(616) 331-3140
Mailing address
3707 CRYSTAL ST SW, GRANDVILLE, MI 49418-1368
(616) 498-4709

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
03/21/2006
Last updated
07/08/2007
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