Most Relevant Information
Provider Data
| NPI Number: | 1003298795 |
| Provider Name: | SENOVIA WICKS |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/18/2015 |
| Last Updated: | 06/18/2015 |
Provider Practice Location
102 SURREY RD
SAINT LOUIS
MI
488809449
Practice Location Phone/Fax
| Phone: | 9897637896 |
| Fax: |
Provider Mailing Location
102 SURREY RD
SAINT LOUIS
MI
488809449
Provider Mailing Phone/Fax
| Phone: | 9897637896 |
| Fax: |