| NPI | 1558790584 |
|---|---|
| Former Legal Business Name | WICKISER PHYSICAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | CLAYTON W WICKISER President 864-226-8688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 14773) |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2022-05-09 |