BART WICKERSHAM

GALLUP, NM
NPI1700280005
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy163W00000X Registered Nurse
(Licence: KS  13-65413-112)
Enumeration Date2014-10-15
Last Update Date2014-10-15
Business Address
BART WICKERSHAM RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1790
Mailing Address
BART WICKERSHAM RN
516 EAST NIZHONI BVLD.
GALLUP, NM 87301
Phone number: 505-722-1790
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