| NPI | 1629716964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN ELLIOTT Director, Operations 231-360-0183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology |
| 208800000X Urology | |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2022-08-15 |