| NPI | 1518005032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE THOMPSON CFO 517-975-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2018-08-02 |