| NPI | 1770985814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS NUNNALLY Owner / Authorized Official 248-990-2469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 5101016846) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2014-09-19 |