NPI | 1497923304 |
---|---|
Entity Type | Organization |
Authorized Contact | CHRISTOPHER D. WILHELM Owner 248-828-3300 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MI CW045808) |
Enumeration Date | 2008-02-13 |
Last Update Date | 2018-05-23 |