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1437770625
SHANA ROSE WICKLUND
EAST GREENWICH, RI
NPI
1437770625
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant Surgical
Additional Taxonomies
363A00000X Physician Assistant
Enumeration Date
2020-04-29
Last Update Date
2023-11-06
Business Address
SHANA ROSE WICKLUND
1672 S COUNTY TRL STE 302
EAST GREENWICH, RI 02818-5099
Phone number: 401-336-3770
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Mailing Address
SHANA ROSE WICKLUND
25 BROOKWOOD DR
NORTH SCITUATE, RI 02857-1576
Phone number: 401-787-4684
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