Organization
LAKESHORE EAR AND HEARING ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN KAY JOHNSTON (CO-OWNER)
(616) 847-3144
Entity
Organization
Contact information
Practice address
1101 COLUMBUS AVE, GRAND HAVEN, MI 49417-1556
(616) 847-3144
Mailing address
1101 COLUMBUS AVE, GRAND HAVEN, MI 49417-1556
(616) 847-3144
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
—
—
Other
Enumeration date
05/27/2010
Last updated
05/27/2010
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