| NPI | 1922488436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE WILHELM Chief Operations Officer 231-547-8511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2015-06-01 |