| 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 |