| NPI | 1598865735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA REGINALDO Am 586-771-4820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 208800000X Urology |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2024-05-23 |