Individual
MANDY L GWALTNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7540W BROWN RD, MANISTIQUE, MI 49854-9555
(906) 341-5975
Mailing address
7540W BROWN RD, MANISTIQUE, MI 49854-9555
(906) 341-5975
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
07/07/2015
Last updated
07/07/2015
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