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1003434507
ETHAN J LACOURT
GRAND RAPIDS, MI
NPI
1003434507
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601010844)
Enumeration Date
2020-07-10
Last Update Date
2024-12-10
Business Address
Mr. ETHAN J LACOURT PA-C
275 MICHIGAN ST NE
GRAND RAPIDS, MI 49503-2531
Phone number: 616-267-7900
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Mailing Address
Mr. ETHAN J LACOURT PA-C
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number:
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