| NPI | 1750564910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MAX ELLIS Member 248-489-4044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: MI 2301008416) |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2020-12-10 |