Individual
SHANE LILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(517) 899-6035
Mailing address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010823
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003878539
—
MI
Enumeration date
01/05/2021
Last updated
01/05/2021
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