Provider First Line Business Practice Location Address:
1179 EAST PARIS AVE SE #100
Provider Second Line Business Practice Location Address:
COMPREHENSIVE EAR, NOSE AND THROAT, P.C.
Provider Business Practice Location Address City Name:
GRAND RAPIDS TOWNSHIP
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49546
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
616-942-0380
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/10/2009