| NPI | 1508307273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN L JONES Associate Athletic Trainer 989-774-6687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MI 2601000874) |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2017-03-15 |