JORDAN M WAGNER

NILES, MI
NPI1831383074
Former NameJORDAN M FRIZZO
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: MI  5601005116)
Enumeration Date2007-08-30
Last Update Date2013-03-14
Business Address
-- JORDAN M WAGNER PA
2002 S 11TH ST
NILES, MI 49120-4074
Phone number: 269-687-0200
Mailing Address
-- JORDAN M WAGNER PA
6416 DEANS HILL RD
BERRIEN CENTER, MI 49102-9750
Phone number: 269-471-7741
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