| NPI | 1922069400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH J KINGSBURY Business Manager 989-797-3025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology |
| 2086S0129X Surgery Vascular Surgery | |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2020-08-22 |