| NPI | 1871600437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORLANDO IVAN BENEDICT Owner/President 810-694-9903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: MI 4301060730) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2010-07-28 |