Individual
MARY WOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4675 HILL ST, CASS CITY, MI 48726-1099
(989) 872-2121
Mailing address
7021 WINN RD, LYNN, MI 48097-1522
(810) 300-5142
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704196723
MI
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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