| NPI | 1316194640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD W SHELTON Sole Proprietor 586-293-1868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MI 4301088798) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2014-10-08 |