Individual
BARRY D WICKLUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7017 CARMEN BLVD, LAS VEGAS, NV 89128-3406
(702) 445-5995
Mailing address
7017 CARMEN BLVD, LAS VEGAS, NV 89128-3406
(702) 445-5995
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
01/06/2012
Last updated
01/06/2012
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