| NPI | 1144767351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD ELLISON Owner 248-971-4880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MI 4301068024) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-04-25 |