NPI | 1548436421 |
---|---|
Entity Type | Organization |
Authorized Contact | DAN FENWICK Director 313-389-7548 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MI 6401005512) |
Enumeration Date | 2008-05-01 |
Last Update Date | 2008-05-01 |