Individual
MS. LAURAL K WAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
15855 19 MILE RD, CLINTON TWP, MI 48038-3504
(800) 653-6568
(313) 876-1305
Mailing address
15855 19 MILE RD, CLINTON TWP, MI 48038-3504
(800) 653-6568
(313) 876-1305
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704207208
MI
Other
Enumeration date
10/20/2010
Last updated
02/17/2021
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