| NPI | 1023414851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA CRYSTAL MOSURE-JUDGE Owner 248-783-7169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MI 2301009849) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2014-11-05 |