| NPI | 1952984460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH YOUNG Office Manager 248-230-8829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2021-05-03 |