| NPI | 1518367754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN VAN SKYHOCK Owner 231-922-0219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MI 2301009140) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2014-08-25 |