| NPI | 1255439253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY WHITFIELD Medical Svcs Mngr 248-997-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: MI 5101006815) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |