| NPI | 1952575664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN DUMAS Credentialing/Biller 734-282-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care (Licence: MI AS058649) |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care (Licence: MI MA057571) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-15 |