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Organization
GRAND RAPIDS THORACIC SURGERY, PLLC
Active
Organization
GRAND RAPIDS THORACIC SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOURENS J. WILLEKES II M.D. (OWNER)
(616) 259-7341
Entity
Organization
Contact information
Practice address
4500 CASCADE RD SE, SUITE 210, GRAND RAPIDS, MI 49546-3665
(616) 259-7341
(616) 259-7642
Mailing address
4500 CASCADE RD SE, SUITE 210, GRAND RAPIDS, MI 49546-3665
(616) 259-7341
(616) 259-7642
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
4301104138
MI
Other
Enumeration date
12/30/2015
Last updated
12/30/2015
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