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1720472301
WAYNE PARK
ROSEVILLE, MI
NPI
1720472301
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172M00000X Mechanotherapist
(Licence: MI L581371)
Enumeration Date
2015-03-23
Last Update Date
2015-03-23
Business Address
Mr. WAYNE PARK LMT
27850 GRATIOT AVE
ROSEVILLE, MI 48066-4803
Phone number: 586-772-5876
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Mailing Address
Mr. WAYNE PARK LMT
57232 NEWPORT LN
WASHINGTON, MI 48094-3033
Phone number: 586-275-8008
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