Individual
WICLIFF BERRIS BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10427 E IDAHO CIR, MESA, AZ 85209-7715
(602) 326-7232
(489) 264-7516
Mailing address
10427 E IDAHO CIR, MESA, AZ 85209-7715
(602) 326-7232
(489) 264-7516
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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