| NPI | 1316145972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA A IGNATOSKI Manager 269-789-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MI 4301033625) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2009-05-29 |