| NPI | 1699858431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA RUCKER Enrollment & Patient Accts Manager 517-884-2976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2018-04-05 |