Individual
RICKETA RENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17600 GEORGE WASHINGTON DR, SOUTHFIELD, MI 48075-2771
(313) 610-0179
Mailing address
17600 GEORGE WASHINGTON DR, SOUTHFIELD, MI 48075-2771
(313) 610-0179
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703116083
MI
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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