| NPI | 1578995304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID DWIGHT BUCKLAND Member 734-657-3942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AK 992389) |
| Enumeration Date | 2013-08-03 |
| Last Update Date | 2013-08-03 |