| NPI | 1740796838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY KEITH WINGATE President 248-228-0054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center Pain (Licence: MI 4301088960) |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2017-12-27 |