Individual
LISA WIESEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
527 COBB ST, CADILLAC, MI 49601-2540
(231) 775-3463
Mailing address
527 COBB ST, CADILLAC, MI 49601-2540
(231) 775-3463
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
4704300472
MI
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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