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 |