| NPI | 1376558122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA JEAN FAVERO Administrator 810-985-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI BF064615) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2021-11-24 |