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1336724236
GARRY WAYNE WICKLIFFE
TYLER, TX
NPI
1336724236
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
246ZC0007X Specialist/Technologist, Other, Surgical Assistant
(Licence: TX SA00957)
Enumeration Date
2021-03-11
Last Update Date
2024-03-31
Business Address
GARRY WAYNE WICKLIFFE LSA, CST
704 S FLEISHEL AVE
TYLER, TX 75701-2014
Phone number: 903-646-5350
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Mailing Address
GARRY WAYNE WICKLIFFE LSA, CST
2320 KAYNELL DR
HENDERSON, TX 75654-4718
Phone number: 936-635-3169
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