| NPI | 1578148375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID R HICKLING Owner 586-684-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| 207QS0010X Family Medicine, Sports Medicine | |
| Enumeration Date | 2021-03-12 |
| Last Update Date | 2023-07-25 |