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1003122169
JEFFERY DALE WIRGAU
ALPENA, MI
NPI
1003122169
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: MI 5601005846)
Enumeration Date
2010-08-27
Last Update Date
2010-08-27
Business Address
-- JEFFERY DALE WIRGAU PAC
400 JOHNSON ST
ALPENA, MI 49707-1434
Phone number: 989-356-2161
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Mailing Address
-- JEFFERY DALE WIRGAU PAC
3267 W NICHOLSON HILL RD
OSSINEKE, MI 49766-9722
Phone number: 989-590-1977
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