| NPI | 1740505601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE PRADKO Manager 586-948-3350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 4301060263) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2010-04-05 |