| NPI | 1649278748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYSSA CHRZANOWSKI Office Manager/Biller 810-202-7115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301063298) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2026-04-14 |