Individual
LISA MARIE WARACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2463 S M 30, WEST BRANCH, MI 48661-9312
(989) 343-3261
Mailing address
4790 W M 76, WEST BRANCH, MI 48661-8921
(989) 345-2791
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004189
MI
Other
Enumeration date
04/09/2007
Last updated
02/13/2013
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