| NPI | 1629251129 |
|---|---|
| Other Name | BAYSIDE FAMILY & SPORTS MEDICINE PC |
| Entity Type | Organization |
| Authorized Contact | TODD EDWARD DECKER Owner/President 231-439-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2012-04-10 |