| NPI | 1578547071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITZIE J HEWITT Owner 231-269-4185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: MI 5101013101) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2021-03-24 |