| NPI | 1801291653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET C PROCTOR Owner 517-240-8314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CO 1986) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2014-10-22 |