| NPI | 1386218055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY EARNEST Manager 231-755-6038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2021-05-18 |