| NPI | 1558457663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA K MCCOWEN Member/Owner 906-226-6790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI D05942) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |