| NPI | 1972871929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE J TALASKI RN, Qi/Qi Manager 989-358-4251 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI AA036532) |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2011-12-06 |