| NPI | 1235234782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELEN E NICKLES Billing Office Manager 989-354-0845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MI CG041826) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-08-22 |