NPI | 1255427209 |
---|---|
Entity Type | Organization |
Authorized Contact | STACEY MARIE MONTECILLO Practice Manager 586-228-0400 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101009509) |
Enumeration Date | 2006-10-05 |
Last Update Date | 2024-06-03 |