| NPI | 1902170202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY MICHELLE LEWIS Co Owner 269-267-7097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201006821) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MI 5201007594) |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2017-03-22 |