| NPI | 1225371495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA THOMPSON Vice President 810-288-1155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MI 1013271923) |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2013-04-05 |