Organization
OTTAWA SHORES ENT ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARAH A COOKE (OFFICE MANAGER)
(616) 935-6966
Entity
Organization
Contact information
Practice address
1445 SHELDON ROAD, SUITE 304, GRAND HAVEN, MI 49417-2480
(616) 935-6966
(616) 935-6967
Mailing address
1445 SHELDON ROAD, SUITE 304, GRAND HAVEN, MI 49417-2480
(616) 935-6966
(616) 935-6967
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301063104
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4422643
—
MI
Enumeration date
10/04/2006
Last updated
08/22/2020
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