| NPI | 1669479564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIJAY MISHRA Alternate Administrator, Ot 586-872-5133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2022-07-21 |