| NPI | 1770818650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER MAIDLOW President 989-583-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2009-10-09 |