MARK WEATHERWAX

KALAMAZOO, MI
NPI1841768421
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MI  6301015902)
Enumeration Date2018-11-13
Last Update Date2018-11-13
Business Address
MARK WEATHERWAX MS
519 S PARK ST
KALAMAZOO, MI 49007-5117
Phone number: 269-903-0551
Mailing Address
MARK WEATHERWAX MS
519 S PARK ST
KALAMAZOO, MI 49007-5117
Phone number: 269-903-0551
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