KARL THEODORE WICKSTROM

PRESCOTT, AZ
NPI1669476123
Other NameTED WICKSTROM
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2085R0202X Radiology, Diagnostic Radiology
(Licence: AZ  21726)
Enumeration Date2005-06-10
Last Update Date2013-02-28
Business Address
-- KARL THEODORE WICKSTROM M.D.
790 GAIL GARDNER WAY
PRESCOTT, AZ 86305-2337
Phone number: 928-776-9900
Mailing Address
-- KARL THEODORE WICKSTROM M.D.
790 GAIL GARDNER WAY
PRESCOTT, AZ 86305-2337
Phone number: 928-776-9900
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