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1487684775
RYAN P WICKER
SHREVEPORT, LA
NPI
1487684775
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: LA 5526)
Enumeration Date
2006-07-03
Last Update Date
2007-07-08
Business Address
-- RYAN P WICKER DDS
8789 LINE AVE
SHREVEPORT, LA 71106-6813
Phone number: 318-865-1600
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Mailing Address
-- RYAN P WICKER DDS
8789 LINE AVE
SHREVEPORT, LA 71106-6813
Phone number: 318-865-1600
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