| NPI | 1174142673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY BARKER Credentialing Manager 734-373-0849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2024-07-15 |