Individual
KICKI SARA WEHLOU
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
85-87 SPRING STREET, CO DR WILLET, LACONIA, NH 03246
(603) 527-7121
Mailing address
LANDMARK INN, 480 MAIN STREET, LACONIA, NH 03246
(603) 455-8036
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
167486
NY
208000000X
Pediatrics Physician
Primary
LT2245
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
167486
NYS
—
Enumeration date
05/10/2006
Last updated
03/07/2023
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