| NPI | 1982170312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDOLPH KUMMLER President 810-424-2025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2020-08-18 |