Individual
LORETTA LOUISE WICKWARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
521 S 7TH AVE, YUMA, AZ 85364-2968
(619) 602-7636
Mailing address
521 S 7TH AVE, YUMA, AZ 85364-2968
(619) 602-7636
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
10/20/2021
Last updated
10/20/2021
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