| NPI | 1912365032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY JOHN CARROLL President 586-436-3785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2024-07-09 |