NPI | 1528680816 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA JANELLE WOLSKE CEO 269-462-9587 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 207Q00000X Family Medicine |
261QX0100X Clinic/Center, Occupational Medicine | |
363A00000X Physician Assistant | |
363LC1500X Nurse Practitioner, Community Health | |
Enumeration Date | 2020-05-11 |
Last Update Date | 2021-11-01 |