WADE WYCKOFF

SHREVEPORT, LA
NPI1689243149
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy208100000X Physical Medicine & Rehabilitation
(Licence: LA  346157)
Enumeration Date2021-06-20
Last Update Date2025-10-14
Business Address
WADE WYCKOFF
1111 LINE AVE
SHREVEPORT, LA 71101-3841
Phone number: 318-716-4545
Mailing Address
WADE WYCKOFF
1111 LINE AVE
SHREVEPORT, LA 71101-3841
Phone number: 318-716-4545
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