| NPI | 1114357084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORI EILEEN CARSON DEAN Office Manager/Managing Member 810-422-8013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2023-11-02 |