| NPI | 1619007051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD B ROTH Owner 231-487-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301046012) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |