JOHN WILLIAM WICKENBURG

SANTA ROSA, CA
NPI1750432597
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
(Licence: CA  17669)
Enumeration Date2007-01-16
Last Update Date2007-07-08
Business Address
Mr. JOHN WILLIAM WICKENBURG P.T.
401 BICENTENNIAL WAY
SANTA ROSA, CA 95403-2149
Phone number: 707-571-4633
Mailing Address
Mr. JOHN WILLIAM WICKENBURG P.T.
1684 NORTE WAY
SANTA ROSA, CA 95404-2611
Phone number: 707-525-1988