| NPI | 1750530721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY J CHANDLER Physician 517-482-1183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 5101006090) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101006090) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2008-09-15 |