Individual
MS. DIANE MARIE WICK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6012 S LINDEN RD, STE 15, SWARTZ CREEK, MI 48473
(810) 655-8244
(810) 655-2192
Mailing address
12400 ALCOY DR, FENTON, MI 48430
(810) 629-8321
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501002417
MI
Other
Enumeration date
03/28/2006
Last updated
07/08/2007
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