| NPI | 1811412091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALIA LYNELL FOX Founder, Medical Director 269-998-0683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: WI 55919-20) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2017-08-08 |