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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