| NPI | 1356504427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY E. SHORT Physician/President 734-904-2496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 5101011718) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2008-08-04 |