| NPI | 1508418252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM KNOERL Controller 231-832-7177 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2019-07-12 |