| NPI | 1669662037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES PATRICK WHALEN Owner 313-592-4556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MI 2301004806) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2007-07-31 |