| NPI | 1538470505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA FOSNAUGH AVIS Director 248-353-6880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MI PENDING) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2010-10-15 |