| NPI | 1255832382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT EDWARD POLEY Managing Member 586-416-6260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2018-05-25 |