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Individual

MAUREEN ANNE LILLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
A.T.C.

Contact information

Practice address
46591 ROMEO PLANK RD, MACOMB, MI 48044-5742
(586) 226-6504
(586) 226-6505
Mailing address
36 ROSEBUD LN, MOUNT CLEMENS, MI 48043-1470
(586) 226-6504
(586) 226-6505

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
01/05/2007
Last updated
07/08/2007
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