| NPI | 1801152590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN CIPULLO President 248-773-8923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MI 4301078278) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2014-03-30 |