| NPI | 1912903212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN BRUCE CORBIN Owner/President 989-779-9089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MI 5601002173) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2020-08-22 |