| NPI | 1669512000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES PARKER VANWAGNER Owner 231-935-0957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI JV009579) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |