| NPI | 1669925400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA ROGERS Program Director 810-606-5126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301110675) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2016-07-28 |