KELLY WICKSTROM

TUCSON, AZ
NPI1083092589
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207RC0200X Internal Medicine Critical Care Medicine
(Licence: AZ  008816)
Additional Taxonomies207R00000X Internal Medicine
(Licence: AZ  008816)
207R00000X Internal Medicine
(Licence: AZ  R2504)
207RP1001X Internal Medicine Pulmonary Disease
(Licence: AZ  008816)
Enumeration Date2015-05-15
Last Update Date2023-04-29
Business Address
KELLY WICKSTROM D.O.
5301 E GRANT RD
TUCSON, AZ 85712-2805
Phone number: 520-324-5696
Mailing Address
KELLY WICKSTROM D.O.
1501 N CAMPBELL AVE RM 6336 BOX 245040
TUCSON, AZ 85724-5040
Phone number: 520-626-7000