| NPI | 1730292392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN CRAIG BOSS Physician 231-547-3124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301069390) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2011-12-05 |