| NPI | 1578530630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID DESTRISAC Medical Director 517-272-1063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MI 336817) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2008-03-13 |