| NPI | 1467624379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA FOSNAUGH AVIS Clinic Director 248-353-6880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2008-03-31 |