| NPI | 1578726519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY CNOSSEN Billing Manager 231-995-4902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MI 1601000288) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MI 1601000245) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2009-04-08 |