Michael D Wagner
Michael D Wagner is an Adult Care Home Facility in Grand Rapids, Michigan. Practices as a sole proprietor. Licensed in Michigan.
- Licensed in
- MI
- In the registry since
- 2017
Practice location Address checks out
807 Pine Ave NWGrand Rapids, MI 49504-4340
Phone: (616) 776-7094
Fax: (616) 776-7094
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Adult Care Home Facility (primary) | Taxonomy 311ZA0620X · Licence AF410387497 (MI) |
|---|
Record details
| NPI number | 1336655034 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | December 18, 2017 |
| Last updated in NPPES | December 18, 2017 |
| Mailing address | 807 Pine Ave Nw, Grand Rapids, MI 49504-4340 |
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