| NPI | 1174725287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA JEAN VARGA Member 586-727-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 950E021250) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: MI 950E019860) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2008-08-21 |