JAN MIRIAM JACOB-WICKLAND

SAINT LOUIS, MO
NPI1508980541
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MO  119559)
Enumeration Date2007-03-16
Last Update Date2019-02-20
Business Address
JAN MIRIAM JACOB-WICKLAND PA-C
615 S NEW BALLAS RD DEPT OF
SAINT LOUIS, MO 63141-8221
Phone number: 314-251-6000
Mailing Address
JAN MIRIAM JACOB-WICKLAND PA-C
1054 BIG BEND STATION DR
MANCHESTER, MO 63088-1429
Phone number: 636-861-1102
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