| NPI | 1013537802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEODGE HILL Owner 734-699-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-08-12 |