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1033189071
LARRY A WICKLESS
FARMINGTON HILLS, MI
NPI
1033189071
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RG0100X Internal Medicine, Gastroenterology
(Licence: MI 5101005865)
Enumeration Date
2006-01-24
Last Update Date
2007-07-08
Business Address
-- LARRY A WICKLESS M.D.
28080 GRAND RIVER AVE SUITE 306
FARMINGTON HILLS, MI 48336-5966
Phone number: 248-471-8982
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Mailing Address
-- LARRY A WICKLESS M.D.
28080 GRAND RIVER AVE SUITE 306
FARMINGTON HILLS, MI 48336-5966
Phone number: 248-471-8982
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