| NPI | 1154567279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY M. DICKSON President 231-932-1250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MI 4301062201) |
| Enumeration Date | 2008-12-18 |
| Last Update Date | 2013-08-27 |