| NPI | 1669975678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI ANN DILLARD Owner/Physician 586-799-7682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MI 5101014290) |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |