| NPI | 1588824866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL WESEN Board President 586-416-7575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MI 506857) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-09-23 |