NPI | 1992086680 |
---|---|
Entity Type | Organization |
Authorized Contact | THEODORE G ENGELMANN Owner 2486-200-3777 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI TE007018) |
Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: MI TE007018) |
Enumeration Date | 2011-09-08 |
Last Update Date | 2011-09-08 |