| NPI | 1457563223 |
|---|---|
| Other Name | ON HOLD |
| Entity Type | Organization |
| Authorized Contact | JEANNE' WICKENS Senior Vice President Of Finance 517-788-6979 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2008-05-14 |