| NPI | 1518027606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT PHILIP ZACK Board Member 248-626-6892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101010930) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301064477) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2008-12-11 |