| NPI | 1619981891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY PLOEHN Owner 269-979-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: MI 4301059704) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2010-07-12 |