| NPI | 1205111465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN KELLER Administrator 248-952-4340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MI 5501009589) |
| Additional Taxonomies | 261QX0100X Clinic/Center, Occupational Medicine (Licence: MI 5201009157) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2019-05-10 |