| NPI | 1134588551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLER SUYDAM Owner 517-410-2840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 2301010348) |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2017-01-16 |