Individual
FRANCES MARIE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12720 LINCOLN LAKE AVE, GOWEN, MI 49326-9403
(616) 548-2838
Mailing address
12720 LINCOLN LAKE AVE, GOWEN, MI 49326-9403
(616) 548-2838
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AF410215936
MI
Other
Enumeration date
06/01/2017
Last updated
07/21/2022
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