| NPI | 1184987638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY E WHITEUS Owner 313-629-5140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301406556) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2012-06-20 |