| NPI | 1104206978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX OLKHOVSKY Chairman Of The Board Of Directors 248-933-1224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MI 4301094678) |
| 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine | |
| 261QU0200X Clinic/Center Urgent Care | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2016-03-11 |