| NPI | 1720259005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WALTER PANKONIN President 989-793-0510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI MP035123) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2008-03-14 |