| NPI | 1831470285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE LINCOLN PRIDE Physician Assistant 269-385-9900 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601006118) |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2011-08-30 |