| NPI | 1992393417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTWAN FARAJ Owner/Member 586-871-4805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2021-01-10 |
| Last Update Date | 2021-01-10 |