| NPI | 1518262096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON C HERBENER Doctor/Owner 517-437-5385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI jh033911) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 5101018596) |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2011-01-14 |