| NPI | 1598807737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI R FRALEY Office Coordinator 906-225-3936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301054887) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2008-07-28 |