| NPI | 1770871154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELHAM F ELIA Office Manager 313-366-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MI 207R00000X) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-07-20 |