| NPI | 1881734143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE L HENRY Owner 586-574-4417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MI 4301066091) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301066091) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: 4876080001) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2009-06-05 |