| NPI | 1871926543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN HAYES Practice Administrator 810-733-7111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI GK407137) |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2013-08-16 |