| NPI | 1235648700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY MURRAY Administrative Assistant 810-392-2167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: MI SA0110112) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2017-09-27 |