| NPI | 1750470589 |
|---|---|
| Other Name | ST JOHN WEIGHT LOSS CENTER |
| Entity Type | Organization |
| Authorized Contact | SANDRA ELLEN WHITMAN Director Pbs 248-746-3218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2007-08-08 |