NPI | 1770478992 |
---|---|
Entity Type | Organization |
Authorized Contact | AMMAR TANK Authorized Official 248-730-1403 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2025-06-09 |
Last Update Date | 2025-06-09 |