| NPI | 1629332218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIJAYA CHALLA Owner/Physicia 810-449-5456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI VC080035) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2012-06-27 |