| NPI | 1477029239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY FORD Office Manager 989-846-9545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2020-10-26 |