| NPI | 1962463133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA FOREMAN-LOVELL Administrator 248-514-3056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MI 636907) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2025-11-17 |