| NPI | 1407058209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL FREDERICK Owner 269-637-9099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MI 5501011004) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2013-03-01 |