Individual
FREDERICK WALLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12823 N MACKINAW HWY, MACKINAW CITY, MI 49701-9744
(231) 436-5319
Mailing address
12823 N MACKINAW HWY, MACKINAW CITY, MI 49701-9744
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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