NPI | 1972835205 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIEL T DEGUZMAN Director 734-459-0700 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: MI 4301033522) |
Enumeration Date | 2010-02-11 |
Last Update Date | 2010-02-11 |