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 | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine |
204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MI 4301094678) | |
261QU0200X Clinic/Center, Urgent Care | |
Enumeration Date | 2015-06-05 |
Last Update Date | 2016-03-11 |