| NPI | 1659771426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE GALONSKY President 269-969-6123 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2019-04-26 |