| NPI | 1578852075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BUCKNAM Owner 810-588-4657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301043167) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2011-04-05 |