| NPI | 1902266356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HUTCHINS President 989-854-8334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2016-02-28 |
| Last Update Date | 2021-03-25 |