PETER L WICKENS D.O.,P.C.
Ambulatory Health in Warren, MI

License number
Michigan 5101006061
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DR. PETER L WICKENS D.O.
Title: PRESIDENT
Phone: (586) 293-2088
Address
Address
14050 Mile Rd, Warren, MI 48088
National Provider ID: 1003083957
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PETER L. WICKENS D.O., PC

14050 14 Mile Rd, Warren, MI 48088

Status:
Inactive
Registration:
Jan 1, 1974
State ID:
134919
Business type:
Domestic Professional Service Corporation
Expiration:
7-15-2006
Agent:
Peter L Wickens

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