| NPI | 1912049099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN TARTAGLIONE Owner 810-424-2007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004125) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2007-09-20 |