NPI | 1467631804 |
---|---|
Entity Type | Organization |
Authorized Contact | CARL ANTHONY OGAS Owner 231-739-2192 |
Organization Subpart ? | No |
Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: MI 4301062711) |
Enumeration Date | 2007-11-02 |
Last Update Date | 2008-07-01 |