| NPI | 1245096908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN A, GRANT Managing Member 248-761-4683 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2024-02-21 |
| Last Update Date | 2024-02-21 |