| NPI | 1700962339 |
|---|---|
| Former Legal Business Name | HOLLY ROAD MEDICAL ASSOCIATES, PC |
| Entity Type | Organization |
| Authorized Contact | ROLAND TINDLE CEO 810-695-8011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101006592) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301048801) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2012-03-01 |