| NPI | 1447499348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY LEE BOGGESS President 734-761-3450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MI 5101016620) |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2009-02-17 |