| NPI | 1851715585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR I CORONDAN Owner 248-837-9419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 4301059864) |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2014-04-24 |