| NPI | 1164264438 |
|---|---|
| Doing Business As | AZOTH ALLSPIRITUS, LLC |
| Entity Type | Organization |
| Authorized Contact | JASON HAWKINS Chief Medical Officer 313-980-7067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101Y00000X Counselor |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2024-06-08 |
| Last Update Date | 2024-06-08 |