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1114937661
CAROLYN KAY WICKENKAMP
COEUR D ALENE, ID
NPI
1114937661
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: WA MD00034130)
Enumeration Date
2006-08-08
Last Update Date
2007-07-08
Business Address
CAROLYN KAY WICKENKAMP MD
8795 W DRIFTWOOD DR
COEUR D ALENE, ID 83814-9602
Phone number: 208-777-8427
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Mailing Address
CAROLYN KAY WICKENKAMP MD
15425 E MISSION AVE
SPOKANE VALLEY, WA 99037-9505
Phone number: 509-924-7010
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