| NPI | 1891508891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAKA CHIPAWE Owner 269-277-0952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2025-01-31 |
| Last Update Date | 2025-02-07 |