| NPI | 1821274150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA WALKERDINE ROGERS Proprietor 231-922-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101016224) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-01-16 |