| NPI | 1235699646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONY BURKE COO 586-393-5041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2019-03-21 |