| NPI | 1184793408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA ELLISON Accounting Manager 231-728-1678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI SF064116) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2008-03-31 |