| NPI | 1518599356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RELANDA PRICE Lead Enrollment COO Rdinator 517-884-2976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2022-10-14 |