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1225566003
CARLY GAIL WAGONSCHUTZ
EAST LANSING, MI
NPI
1225566003
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: MI 5202008251)
Enumeration Date
2017-05-24
Last Update Date
2017-05-24
Business Address
Ms. CARLY GAIL WAGONSCHUTZ COTA/L
2530 MARFITT RD
EAST LANSING, MI 48823-6343
Phone number: 866-486-8811
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Mailing Address
Ms. CARLY GAIL WAGONSCHUTZ COTA/L
1217 SCHAVEY RD
DEWITT, MI 48820-9523
Phone number: 517-749-5320
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