Individual provider · Type 1 NPI

Mary Lane, PTA

Physical Therapy Assistant · Clinton Township, MI

NPI number 1649801614 Active

Practice location

15520 19 Mile Rd Ste 450
Clinton Township, MI 48038-6332

Call (586) 416-2000 Map

Fax (586) 416-2013

Mailing address

33900 Harper Ave Ste 104
Clinton Township, MI 48035-4258

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X5502005859 (MI)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1649801614

Mary Lane, PTA's National Provider Identifier is 1649801614, issued on Jan 29, 2020. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Clinton Township, MI. The record was last updated on Apr 2, 2026.