| NPI | 1477109528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABLA M SOUEIDAN Owner 313-207-5767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2019-08-14 |