| NPI | 1316572134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RELANDA PRICE Lead Enrollment Coordinator 517-884-2976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 208D00000X General Practice | |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2025-11-25 |