| NPI | 1972868321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD W EASTON Medical Director 248-215-8095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301051364) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301054228) |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301075858) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MI 4301087222) | |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2024-05-06 |