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 |