| NPI | 1962017780 |
|---|---|
| Former Legal Business Name | B & G CLINICAL SERVICES INC |
| Entity Type | Organization |
| Authorized Contact | JULIE BUMPUS Owner 734-730-8445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2023-01-28 |