| NPI | 1215366893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY L FORTUNE Office Manager 269-687-9575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301079120) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2014-01-08 |