| NPI | 1669955894 |
|---|---|
| Doing Business As | IHA SOUTH LYON PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | CYNTHIA A ELLIOTT President/COO 734-327-0872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2019-12-27 |