| NPI | 1649302035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L DEAN Owner 734-213-4901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 5101014751) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |