| NPI | 1124321005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY KARMON Owner 269-806-8650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: MI 2301006062) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2024-05-15 |