| NPI | 1174976740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R SANBORN Co Owner Authorized Official 248-647-9860 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007743) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-07-19 |