| NPI | 1477088904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ECKER Director, Billing De PT 810-262-9952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2024-04-12 |