Healthcare Provider Details

I. General information

NPI: 1003044116
Provider Name (Legal Business Name): DINA M WURMLINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 06/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 GRATIOT BLVD
MARYSVILLE MI
48040-1145
US

IV. Provider business mailing address

7211 PARK AVE
LEXINGTON MI
48450-9353
US

V. Phone/Fax

Practice location:
  • Phone: 810-388-1200
  • Fax:
Mailing address:
  • Phone: 810-388-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: