NPI | 1740439025 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK A JACKSON Physician/Owner 231-935-0913 |
Organization Subpart ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MI 4301051555) |
Enumeration Date | 2008-09-11 |
Last Update Date | 2008-12-18 |