| NPI | 1225648777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE STANLEY Owner 248-470-3224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2020-08-08 |
| Last Update Date | 2020-08-08 |