| NPI | 1225085079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON V MOBLEY Physician/Owner 517-853-0781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101014250) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601003908) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: MI 5101014250) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2012-09-17 |