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General NPI Number Information
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NPI Number | 1295778181
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Entity Type | Individual
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Provider Name | SHANE LELAND STANLEY DC
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 26090 LANNYS RD
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City | NOVI
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State | MI
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Zip | 48375-1022
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Country | US
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Telephone | 228-883-2741
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Fax |
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Provider Business Mailing Address
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Address Line | 26090 LANNYS RD
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City | NOVI
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State | MI
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Zip | 48375-1022
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Country | US
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Telephone | 248-883-2741
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | SS008515
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License Number State | MI
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