| NPI | 1629494133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIDRE WELLER Controller 269-945-1212 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2016-04-22 |