| NPI | 1063639870 |
|---|---|
| Doing Business As | GRAND RAPIDS EAR NOSE AND THROAT PC |
| Entity Type | Organization |
| Authorized Contact | THOMAS W PFENNIG Owner 616-249-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2015-07-09 |