Individual
HEIDI WENZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
43825 MICHIGAN AVE, CANTON, MI 48188-2551
(734) 397-3088
Mailing address
43825 MICHIGAN AVE, CANTON, MI 48188-2551
(734) 397-3088
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703103465
MI
Other
Enumeration date
09/21/2015
Last updated
09/21/2015
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