| NPI | 1558329409 |
|---|---|
| Former Name | MICHELLE RENEE WICKES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NE 1354) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2008022535) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2010-08-02 |