CODY WICKENHAUSER

BLOOMINGTON, IL
NPI1811364052
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: IL  070.021534)
Enumeration Date2015-08-24
Last Update Date2015-08-24
Business Address
-- CODY WICKENHAUSER PT, DPT
2406 E EMPIRE ST
BLOOMINGTON, IL 61704-3630
Phone number: 309-663-9300
Mailing Address
-- CODY WICKENHAUSER PT, DPT
2406 E EMPIRE ST
BLOOMINGTON, IL 61704-3630
Phone number: 309-663-9300
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