| NPI | 1205449204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAYNE GODZINA Owner 231-723-1198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 261QS1200X Clinic/Center, Sleep Disorder Diagnostic | |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2022-07-19 |