| NPI | 1750530473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEGAN JABEZ Owner 269-925-8842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MI 4301064652) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2008-09-18 |