| NPI | 1215989868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ANN O'SULLIVAN Owner 231-838-2765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MI 4301081068) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2007-09-21 |