| NPI | 1790356764 | 
|---|---|
| Doing Business As | DTNA - DETROIT | 
| Entity Type | Organization | 
| Authorized Contact | JONATHAN LEIZMAN President 615-468-6270 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty | 
| Enumeration Date | 2021-07-09 | 
| Last Update Date | 2023-02-06 |