| NPI | 1043542202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY J DESY Receptionist 517-782-2540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 053446) |
| Enumeration Date | 2010-02-12 |
| Last Update Date | 2012-09-10 |