| NPI | 1457652992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA ANN TAYLOR Owner 586-909-1632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 01066927A) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-29 |