| NPI | 1396094926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKLYN PRICE Administrator 313-908-3071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301097600) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |