| NPI | 1487686754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER STITES Health Info Specialist 989-774-6599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208600000X Surgery | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2022-06-23 |