MR. Ethan J Lacourt, PA-C
NPI #1003434507 in Grand Rapids, Michigan
Provider Information
- NPI Number
- 1003434507
- Entity Type
- Individual
- Name
- MR. Ethan J Lacourt, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Jul 10, 2020
- Last Updated
- Dec 10, 2024
Practice Location
- Address
- 275 MICHIGAN ST NE
- City
- Grand Rapids
- State
- Michigan
- ZIP Code
- 49503-2531
- Phone
- (616) 267-7900
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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