| NPI | 1801083951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MARIE CRUBAUGH Partner 563-340-3735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MI 2301009373) |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2007-10-02 |