Individual
KIMBERLY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2970 PIERCE RD, SUITE 2, SAGINAW, MI 48604-8810
(989) 583-0295
(989) 583-0299
Mailing address
1447 N HARRISON ST, SAGINAW, MI 48602-4727
(989) 583-6000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101020682
MI
Other
Enumeration date
06/21/2013
Last updated
08/01/2016
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