| NPI | 1881002491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY KENDALL Practice Manager 734-930-4020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MI 4301060012) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2021-06-17 |