Individual
KATHRYN A WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, 3RD CARDIOVASCULAR CENTER RECP C, ANN ARBOR, MI 48109-5864
(888) 287-1082
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003769
MI
Other
Enumeration date
02/13/2007
Last updated
09/17/2012
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