| NPI | 1275744948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS P BENN Member 810-235-5181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MI 2301004346) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |