| NPI | 1265579734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE THOMPSON CFO 517-975-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QS0010X Family Medicine, Sports Medicine (Licence: MI 5101012213) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2023-11-14 |