| NPI | 1932796240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY BARKER Credentialing Specialist 734-373-0849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2024-02-12 |