NPI | 1023170115 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLY RATOWSKI Director Office Provider Affairs 248-703-2003 |
Organization Subpart ? | No |
Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MI 830190) |
Enumeration Date | 2006-12-14 |
Last Update Date | 2024-03-06 |