| NPI | 1750484556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPHINE A LLANTO Office Manager 269-463-5711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI AL038737) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2010-06-23 |