Individual
SUSAN WAGENSCHUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
4775 24TH AVE, FORT GRATIOT, MI 48059-3405
(810) 385-2164
Mailing address
320 5TH ST, MARYSVILLE, MI 48040-1056
(810) 300-0957
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
5302024562
MI
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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