| NPI | 1558653303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON E MACKENZIE Owner, Pa C 586-246-5125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MI D5298K) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2011-07-21 |