| NPI | 1205006285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY M. KURIAN Billing Manager 906-225-4510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MI 4301061171) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-03-06 |