| NPI | 1255306114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNIE C BAKER Owner 989-343-9466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301085012) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301085011) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2020-08-22 |