| NPI | 1861880742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE STECKO Physician Assistant 248-622-3813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: SC 2241) |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2014-12-31 |