| NPI | 1508065905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LEE DAILL Sole Member 734-823-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 4301089200) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-10-02 |