| NPI | 1164973863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS DONALD NOVAKOSKI Owner 517-614-1245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: MI 2301010249) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |