| NPI | 1194979039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW JOHN LIVINGSTON Owner 616-826-0374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MI 4301061751) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2008-11-05 |