Individual
JOHDINANN MARSHA OLIVE HARTLEY WACLAWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAS
Contact information
Practice address
2200 DENDRINOS DRIVE, SUITE 102, TRAVERSE CITY, MI 49684
(616) 331-5700
(616) 331-5999
Mailing address
1 CAMPUS DRIVE, 2015 JAMES H. ZUMBERGE HALL, ALLENDALE, MI 49401-9403
(616) 331-5700
(616) 331-5999
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/14/2024
Last updated
11/14/2024
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