| NPI | 1235278714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARIANA GRACE RAYMOND Manager Provider Enrollment 734-343-1466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2026-05-04 |