| NPI | 1376690883 |
|---|---|
| Doing Business As | IHA DOMINO'S FARMS PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | CYNTHIA A ELLIOTT VP/Chief Operating Officer 734-747-6766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2019-12-27 |