NPI | 1235141979 |
---|---|
Entity Type | Organization |
Authorized Contact | PAUL ASBURY WALK Owner President 269-969-6000 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301046717) |
207R00000X Internal Medicine (Licence: MI 4301084400) | |
Enumeration Date | 2006-08-12 |
Last Update Date | 2025-09-11 |