| NPI | 1568543528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA BASTIAN Manager 248-373-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2024-02-21 |