NPI | 1497128649 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES F ROOST Resident Agent 517-321-3030 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MI 2301004303) |
Enumeration Date | 2015-11-10 |
Last Update Date | 2023-09-14 |