Individual
BARBARA WIEDMAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
524 W CENTRE AVE, PORTAGE, MI 49024-5306
(269) 324-1180
Mailing address
2121 WAITE AVE, KALAMAZOO, MI 49008-1717
(269) 615-1572
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704155842
MI
Other
Enumeration date
06/07/2018
Last updated
06/07/2018
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