| NPI | 1013248012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS KARL CHERNIN Owner 734-973-3030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MI 4301043276) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CA G88197) |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2010-01-15 |