| NPI | 1467470492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL EDDY Director 269-387-3280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 225100000X Physical Therapist |
| 291U00000X Clinical Medical Laboratory | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2012-01-11 |