| NPI | 1255715520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REVAN FRANCIS Secretary 248-702-6111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: MI 5101016685) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2017-02-08 |