| NPI | 1871663369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN NORMAN GERVAE Owner 906-884-2824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI SG028728) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-08-22 |