| NPI | 1164510574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDY L EBELER Office Manager 734-484-0580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101005511) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2015-06-29 |