| 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 |