| NPI | 1255963401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN HAYES CEO 586-321-6569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| 364S00000X Clinical Nurse Specialist | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2021-03-17 |