| NPI | 1992047252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE THOMPSON CFO 517-975-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 207R00000X Internal Medicine | |
| 208D00000X General Practice | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2018-08-02 |