Organization
COMPREHENSIVE ENT P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK WILEY DELONG M.D. (CEO)
(616) 396-2325
Entity
Organization
Contact information
Practice address
516 LINN ST, ALLEGAN, MI 49010-1525
(616) 396-2325
(616) 396-2325
Mailing address
111 W 24TH ST, HOLLAND, MI 49423-4791
(616) 396-2325
(616) 396-0317
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301029955
MI
Other
Enumeration date
03/06/2008
Last updated
03/06/2008
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