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1750432597
JOHN WILLIAM WICKENBURG
SANTA ROSA, CA
NPI
1750432597
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: CA 17669)
Enumeration Date
2007-01-16
Last Update Date
2007-07-08
Business Address
Mr. JOHN WILLIAM WICKENBURG P.T.
401 BICENTENNIAL WAY
SANTA ROSA, CA 95403-2149
Phone number: 707-571-4633
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Mailing Address
Mr. JOHN WILLIAM WICKENBURG P.T.
1684 NORTE WAY
SANTA ROSA, CA 95404-2611
Phone number: 707-525-1988
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