| NPI | 1730135294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL OTTO President 734-712-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MI 029166) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2010-07-07 |