NPI | 1316295140 |
---|---|
Entity Type | Organization |
Authorized Contact | STEVEN GARFIELD SANDERSON President 906-249-5630 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MI SS007777) |
Enumeration Date | 2012-08-28 |
Last Update Date | 2012-09-13 |