Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mary Lane, PTA

Individual provider Physical Therapy Assistant · NPI 1649801614

Mary Lane, PTA is a Physical Therapy Assistant in Clinton Township, Michigan. Licensed in Michigan. Registered with an NPI since 2020.

Licensed in
MI
In the registry since
2020
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

15520 19 Mile Rd Ste 450
Clinton Township, MI 48038-6332
Phone: (586) 416-2000
Fax: (586) 416-2013
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 5502005859 (MI)

Record details

NPI number1649801614
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedJanuary 29, 2020
Last updated in NPPESApril 2, 2026
Certification dateApril 2, 2026

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