| NPI | 1083203681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT WEBER Credentialing Supervisor 586-350-2644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2021-01-18 |