Individual
ALICIA MARIE WAGANFEALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
600 DENMARK ST, BALDWIN, MI 49304-7500
(231) 745-4648
(231) 745-3724
Mailing address
1805 MILTON AVE APT 127C, BIG RAPIDS, MI 49307-2612
(989) 359-9417
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
5502008588
MI
Other
Enumeration date
05/29/2024
Last updated
06/04/2024
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