| NPI | 1508875840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON WIGGINS Physician 517-346-7628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101013727) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2022-12-11 |