| NPI | 1346787025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRICIA ANN MCGILLS Owner 231-667-7950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2017-02-13 |