| NPI | 1730570342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CROSS Physician 586-778-0664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MI 4301086082) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2015-02-18 |