| NPI | 1285978643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BURGER Clinical Services Supervisor 734-425-0636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MI 6301011507) |
| Enumeration Date | 2012-11-23 |
| Last Update Date | 2012-11-23 |