| NPI | 1013236215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN KAY JOHNSTON Co Owner 616-847-3144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2010-05-27 |