| NPI | 1962953034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK SMITH SVP, Cmo 517-205-6407 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 1060000044) |
| Additional Taxonomies | 207QS0010X Family Medicine Sports Medicine |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2024-03-06 |