| NPI | 1164952388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTES GEORGE Owner 248-595-8742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation (Licence: MI F20199) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-07-21 |