| NPI | 1811235591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIS FAYNE GAFFNEY Physician/Owner 989-831-9009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301050158) |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2013-01-30 |