| NPI | 1003083957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER L WICKENS President 586-293-2088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 5101006061) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2008-05-09 |