| NPI | 1194329961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNA GLEASON Owner/Physician 906-262-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2021-01-04 |