| NPI | 1992455414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE MCCOLLUM Authorized Official 734-837-1048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2022-03-27 |
| Last Update Date | 2022-03-27 |