| NPI | 1588196885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEAUN ANTONIO DOUGLAS Owner/Operator 313-289-3366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-03-28 |