Individual
MACKENZIE MARIE WAGAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5067 55TH ST NW, ROCHESTER, MN 55901-3809
(507) 292-7070
Mailing address
208 4TH ST SW, KASSON, MN 55944-1244
(320) 309-2620
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MN
Other
Enumeration date
09/02/2025
Last updated
09/02/2025
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