Individual
DR. LUKE MONELL WICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3126 S JACKSON AVE STE 200, JOPLIN, MO 64804
(417) 556-3465
Mailing address
3126 S JACKSON AVE STE 200, JOPLIN, MO 64804-2500
(417) 556-3465
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2019012274
MO
208D00000X
General Practice Physician
DOS-1551
HI
Other
Enumeration date
06/14/2012
Last updated
07/19/2019
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