| NPI | 1720475023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KING Controller 269-948-3122 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2020-10-01 |