Individual
WANDA LIDDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1128 ROBERTS ST, MUSKEGON, MI 49442-4133
(231) 740-7856
Mailing address
1128 ROBERTS ST, MUSKEGON, MI 49442-4133
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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