| NPI | 1629263520 |
|---|---|
| Doing Business As | WESTERN WAYNE PHYSICIANS, PLC |
| Entity Type | Organization |
| Authorized Contact | ROBERT J JACKSON Owner / Secretary 313-386-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2008-03-18 |