Individual
BREANNA WICKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
406 S MARKET ST, WICHITA, KS 67202-3904
(315) 737-7207
Mailing address
406 S MARKET ST, WICHITA, KS 67202-3904
(315) 737-7207
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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