Organization
AMANDA WIKAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA WIKAN RD (MANAGER)
(563) 277-2015
Entity
Organization
Contact information
Practice address
250 S MCCORMICK ST, PRESCOTT, AZ 86303-4714
(563) 277-2015
Mailing address
511 ROSE GARDEN CV, PRESCOTT, AZ 86305-2354
(563) 277-2015
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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