Individual
BETH ANN WIEGAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7751 BYRON CENTER AVE SW STE A, BYRON CENTER, MI 49315-8001
(616) 878-3321
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006271
MI
Other
Enumeration date
01/13/2012
Last updated
11/23/2022
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