| NPI | 1790821957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE J TALASKI Hipaa Privacy Official 989-354-2142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MI AA036532) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2007-09-25 |