Organization
GRAND RAPIDS EAR NOSE & THROAT CENTER PLLC
Active
Other names
Ear, Nose and Throat Center, P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MICHAEL KOSTA M.D. (PRESIDENT)
(616) 575-1212
Entity
Organization
Contact information
Practice address
655 KENMOOR AVE SE, SUITE A, GRAND RAPIDS, MI 49546-8622
(616) 575-1212
(616) 575-1219
Mailing address
655 KENMOOR AVE SE, SUITE A, GRAND RAPIDS, MI 49546-8622
(616) 575-1212
(616) 575-1219
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
07/11/2006
Last updated
07/21/2008
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