| NPI | 1265842918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN A OLDHAM Owner 269-325-4115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MI 86000710) |
| Enumeration Date | 2014-05-03 |
| Last Update Date | 2014-05-03 |