| NPI | 1629173026 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | HELEN E NICKLES Billing Office Manager 989-354-0845  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI JS036674)  | 
| Enumeration Date | 2006-09-13 | 
| Last Update Date | 2020-08-22 |