| NPI | 1902057805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH FRANCIS LOOBY Owner 616-942-2675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2008-10-09 |