| NPI | 1013526276 |
|---|---|
| Doing Business As | KETAMINE INSTITUTE OF MICHIGAN SOUTH |
| Entity Type | Organization |
| Authorized Contact | CHRISTA IRENE KLYDER Chief C RN A 734-731-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2020-07-23 |