MICHAEL D WAGNER

GRAND RAPIDS, MI
NPI1336655034
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy311ZA0620X Custodial Care Facility Adult Care Home
(Licence: MI  AF410387497)
Enumeration Date2017-12-18
Last Update Date2017-12-18
Business Address
MICHAEL D WAGNER
807 PINE AVE NW
GRAND RAPIDS, MI 49504-4340
Phone number: 616-776-7094
Mailing Address
MICHAEL D WAGNER
807 PINE AVE NW
GRAND RAPIDS, MI 49504-4340
Phone number: 616-776-7094
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