| NPI | 1841463577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY A LECLAIR Office Coordinator 989-752-8669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI 4301063051) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2009-06-15 |