WALTER JORDAN WICKHAM

POCATELLO, ID
NPI1346843802
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208100000X Physical Medicine & Rehabilitation
(Licence: ID  pt-7106)
Enumeration Date2020-11-18
Last Update Date2020-11-18
Business Address
WALTER JORDAN WICKHAM DPT
1800 FLANDRO DR STE 190
POCATELLO, ID 83202-4940
Phone number: 208-233-2248
Mailing Address
WALTER JORDAN WICKHAM DPT
1800 FLANDRO DR STE 190
POCATELLO, ID 83202-4940
Phone number: 208-233-2248
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