NPI: 1831602481 · CLINTON TWP, MI 48036 · Clinic/Center · NPI assigned 11/06/2017
| Authorized Official | WILSON, STACIE (OWNER) |
| NPI Enumeration Date | 11/06/2017 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 104 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92002 | 104 | 104 | $2K |