| NPI | 1760881726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINIA LYNN WHITAKER Owner 517-227-5246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301078365) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2014-12-29 |