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1003506114
KENNETH JAMES WICKEY
CHARLOTTE, NC
NPI
1003506114
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 0010-13919)
Enumeration Date
2023-05-11
Last Update Date
2024-08-20
Business Address
KENNETH JAMES WICKEY PA
3158 FREEDOM DR STE 3102
CHARLOTTE, NC 28208-0014
Phone number: 704-332-0396
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Mailing Address
KENNETH JAMES WICKEY PA
3158 FREEDOM DR STE 3101
CHARLOTTE, NC 28208-0014
Phone number: 704-348-2992
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