| NPI | 1376916684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRINA MICHELLE WEBER Registered Dietitian 269-873-9108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MI 926499) |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2015-11-09 |