| NPI | 1043919889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA ELIZABETH WALKER Owner/Physician 810-772-8179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 111N00000X Chiropractor | |
| 133VN1501X Dietitian, Registered Nutrition, Sports Dietetics | |
| 171100000X Acupuncturist | |
| 2251S0007X Physical Therapist Sports | |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| 225600000X Dance Therapist | |
| 225700000X Massage Therapist | |
| 363AM0700X Physician Assistant Medical | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-03-01 |
| Last Update Date | 2023-03-01 |