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Organization
LAKELAND MEDICAL PRACTICES
Active
Organization
LAKELAND MEDICAL PRACTICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL KONOPACKI (FINANCE, VP)
(616) 486-9305
Entity
Organization
Contact information
Practice address
42 N SAINT JOSEPH AVE STE 300, NILES, MI 49120-2203
(269) 687-2910
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
237600000X
Audiologist-Hearing Aid Fitter
—
—
332S00000X
Hearing Aid Equipment
—
—
Other
Enumeration date
09/09/2021
Last updated
08/17/2022
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