Individual
MRS. DEANNA RENEE WIRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
20952 E 12 MILE RD STE 110, SAINT CLAIR SHORES, MI 48081-3202
(586) 498-3500
(586) 498-3510
Mailing address
22019 NORMANDY AVE, EASTPOINTE, MI 48021-2511
(586) 776-3728
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5501010198
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F228781
BCBSM
MI
Enumeration date
02/27/2018
Last updated
02/27/2018
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