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1518087352
BETHANY WICKSON
DETROIT, MI
NPI
1518087352
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MI 4704088774)
Enumeration Date
2007-03-29
Last Update Date
2007-07-08
Business Address
BETHANY WICKSON CNP
4201 SAINT ANTOINE ST
DETROIT, MI 48201-2153
Phone number: 313-745-3000
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Mailing Address
BETHANY WICKSON CNP
4201 ST ANTOINE UHC 4B
DETROIT, MI 48201
Phone number: 313-745-0937
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