NPI | 1164186946 |
---|---|
Doing Business As | THEORIA PRIMARY CARE |
Entity Type | Organization |
Authorized Contact | JUSTIN DI REZZE CEO 313-610-8402 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2021-10-27 |
Last Update Date | 2022-03-14 |