| NPI | 1346690245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI NICOLE BASKET Owner 734-945-0482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 510108586) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2018-01-17 |