| NPI | 1801008735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH JAMES Provider Enrollment Coordinator 989-701-4734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI CN083244) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2022-09-27 |