Organization
PETER L WICKENS D.O.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER L WICKENS D.O. (PRESIDENT)
(586) 293-2088
Entity
Organization
Contact information
Practice address
14050 E 14 MILE RD, WARREN, MI 48088-5765
(586) 293-2088
(586) 293-5502
Mailing address
14050 E 14 MILE RD, WARREN, WARREN, MI 48088-5765
(586) 293-2088
(586) 293-5502
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
5101006061
MI
Other
Enumeration date
05/09/2008
Last updated
05/09/2008
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