Individual
MR. WADE DEAN RICKETTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
15840 E MANSFIELD AVE, AURORA, CO 80013-2538
(720) 233-0479
Mailing address
15840 E MANSFIELD AVE, AURORA, CO 80013-2538
(720) 233-0479
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
41928
CO
Other
Enumeration date
07/10/2008
Last updated
07/10/2008
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