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1508390683
LANE OTRHALEK DECRAENE
TROY, MI
NPI
1508390683
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2017-04-17
Last Update Date
2022-07-15
Business Address
LANE OTRHALEK DECRAENE PA
44201 DEQUINDRE RD SUITE EC
TROY, MI 48085-1117
Phone number: 248-964-5111
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Mailing Address
LANE OTRHALEK DECRAENE PA
26901 BEAUMONT BLVD STE 3D
SOUTHFIELD, MI 48033-3849
Phone number: 947-522-1865
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