| NPI | 1689662926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLSWORTH EMIL LUDWIG President 989-631-1221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 040961) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 047857) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2010-10-01 |