| NPI | 1649310632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN THOMAS JACKSON Physican Director 248-465-5300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2010-03-22 |