| NPI | 1104857804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA J WIERSEMA Business Coordinator 989-797-3129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-08-22 |