| NPI | 1659255859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER ANDERSON Co Owner 586-612-0476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-08-01 |
| Last Update Date | 2025-08-01 |