| NPI | 1063955136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY MAINE Director 989-583-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 730061) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2020-09-17 |