# LAKESHORE EAR AND HEARING ASSOCIATES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013236215
- **Authorized official:** KRISTIN KAY JOHNSTON (CO-OWNER)
- **Authorized official phone:** (616) 847-3144

## Contact information

- **Practice address:** 1101 COLUMBUS AVE, GRAND HAVEN, MI 49417-1556
- **Practice address phone:** (616) 847-3144
- **Mailing address:** 1101 COLUMBUS AVE, GRAND HAVEN, MI 49417-1556
- **Mailing address phone:** (616) 847-3144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | Yes |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/27/2010
- **Last updated:** 05/27/2010