| NPI | 1588134779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA AMBROZY Billing Administrator 586-477-1580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2018-11-29 |