BETHANY WICKSON

DETROIT, MI
NPI1518087352
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: MI  4704088774)
Enumeration Date2007-03-29
Last Update Date2007-07-08
Business Address
BETHANY WICKSON CNP
4201 SAINT ANTOINE ST
DETROIT, MI 48201-2153
Phone number: 313-745-3000
Mailing Address
BETHANY WICKSON CNP
4201 ST ANTOINE UHC 4B
DETROIT, MI 48201
Phone number: 313-745-0937
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