| NPI | 1831556992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK E MCCULLOUGH Clinic Director 269-964-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2016-01-20 |