Grand Rapids Ear Nose & Throat Center Pllc
NPI #1124052337 in Grand Rapids, Michigan
Provider Information
- NPI Number
- 1124052337
- Entity Type
- Organization
- Organization Name
- Grand Rapids Ear Nose & Throat Center Pllc
- Primary Specialty
- Otolaryngology
- Enumeration Date
- Jul 11, 2006
- Last Updated
- Jul 21, 2008
Practice Location
- Address
- 655 KENMOOR AVE SE
- Address 2
- SUITE A
- City
- Grand Rapids
- State
- Michigan
- ZIP Code
- 49546-8622
- Phone
- (616) 575-1212
Authorized Official
- Name
- JOHN MICHAEL KOSTA, M.D.
- Title
- PRESIDENT
- Phone
- (616) 575-1212
Specialties & Taxonomy Codes
| Specialty |
|---|
| Otolaryngology |
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