| NPI | 1720259518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN NEAL WILSON President 313-874-5735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: MI 31392) |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: MI AWO31392) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2008-03-19 |