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1306890322
DALE ALAN WICKSTRUM
TALLAHASSEE, FL
NPI
1306890322
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0001X Radiology, Radiation Oncology
(Licence: FL ME0035684)
Enumeration Date
2006-05-22
Last Update Date
2015-11-23
Business Address
-- DALE ALAN WICKSTRUM MD
2003 CENTRE POINTE BLVD
TALLAHASSEE, FL 32308-4893
Phone number: 850-878-2273
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Mailing Address
-- DALE ALAN WICKSTRUM MD
PO BOX 14446
TALLAHASSEE, FL 32317-4446
Phone number: 850-222-4858
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