Organization
SIXTY FOURTH STREET LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW LIVINGSTON MD (MEDICAL DIRECTOR)
(616) 685-3975
Entity
Organization
Contact information
Practice address
2373 64TH ST SW, SUITE 2200, BYRON CENTER, MI 49315-7974
(616) 685-3975
(616) 685-3977
Mailing address
2373 64TH ST SW, SUITE 2200, BYRON CENTER, MI 49315-7974
(616) 685-3975
(616) 685-3977
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
08/22/2006
Last updated
04/23/2018
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