JONATHAN WICKS

BLOOMINGTON, IN
NPI1003341918
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2084S0010X Psychiatry & Neurology, Sports Medicine
(Licence: IN  36002506A)
Enumeration Date2017-04-28
Last Update Date2017-04-28
Business Address
-- JONATHAN WICKS ATC, LAT, M.Ed
1001 E 17TH ST
BLOOMINGTON, IN 47408-1590
Phone number: 812-855-7920
Mailing Address
-- JONATHAN WICKS ATC, LAT, M.Ed
2728 S ADAMS ST UNIT 5
BLOOMINGTON, IN 47403-3296
Phone number: 574-250-9007