NPI | 1457741373 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHELE A RASOR Office Manager 810-227-2767 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MI 5101009380) |
Enumeration Date | 2015-01-30 |
Last Update Date | 2015-01-30 |