NPI | 1225685654 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC JACOB GREENBERG Owner 810-243-5085 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2019-08-21 |
Last Update Date | 2023-02-01 |