Individual
ADRIENNE B WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
5015 N ROYAL DR, TRAVERSE CITY, MI 49684-9292
(231) 935-0850
(231) 935-0869
Mailing address
5015 N ROYAL DR, TRAVERSE CITY, MI 49684-9292
(231) 935-0850
(231) 935-0869
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101020599
MI
Other
Enumeration date
06/03/2013
Last updated
10/22/2020
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