| NPI | 1447689302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LEE DAILL Physician/Owner 734-823-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MI 4704269680) |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2013-11-01 |