| NPI | 1861675530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS HOMNICK Medical Director 269-373-5261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MI 4301044487) |
| Additional Taxonomies | 261QF0050X Clinic/Center Family Planning, Non-Surgical (Licence: MI 4301044487) |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2013-10-29 |