| NPI | 1386767473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE L MITCHELL Owner, Physician 313-701-1187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI M4301056553) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2014-10-06 |