| NPI | 1235442435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALISHA L WATTS Adult Nurse Practitioner 313-465-9892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 4704246644) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2010-11-23 |