| NPI | 1518138882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON COCHRAN Owner 517-267-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MI 5101015359) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 9041) |
| 207X00000X Orthopaedic Surgery (Licence: WV 2233) | |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2014-04-04 |