Individual
KATIE ANN PICUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
800 EAST BLVD, KINGSFORD, MI 49802-4436
(906) 774-4000
(906) 774-0088
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101017482
MI
Other
Enumeration date
08/16/2007
Last updated
10/02/2018
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