| NPI | 1346453396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON THOMAS ANGLIN Office Manager 269-385-4671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI JB033841) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2008-05-02 |