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LOURENS J WILLEKES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
751 LAFEYETTE NW, GRAND RAPIDS, MI 49503
(616) 742-9945
(616) 742-9967
Mailing address
2218 N THRUSH CT SE, GRAND RAPIDS, MI 49546-7525
(616) 742-9945

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301080880
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4507446
MI
Enumeration date
09/13/2006
Last updated
07/08/2007
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