Individual
JEAN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ND
Contact information
Practice address
425 S MAIN ST, STE. 201, ROCHESTER, MI 48307-6729
(248) 881-6220
Mailing address
590 HEMINGWAY RD, LAKE ORION, MI 48362-2629
(248) 881-6220
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
—
—
Other
Enumeration date
05/12/2010
Last updated
05/12/2010
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