| NPI | 1154156420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN HILLARY CFO 810-275-1885 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2024-09-05 |