| NPI | 1699949610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH LAVERN TROLLMAN Owner 810-629-4187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 51010055954) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-04-22 |