| NPI | 1992044598 |
|---|---|
| Doing Business As | WAYNE STATE UNIVERSITY PHYSICIAN GROUP |
| Entity Type | Organization |
| Authorized Contact | JEFFERY P KOHLITZ Chief Financial Officer 248-581-5930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: MI 4301028224) |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2016-12-01 |