Carrie Wickerham

NPI #1215407283 in Festus, Missouri

Provider Information

NPI Number: 1215407283
Entity Type: Individual
Name: Carrie Wickerham
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician
Enumeration Date: Dec 3, 2018
Last Updated: Dec 3, 2018

Practice Location

Address: 227 MAIN ST
City: Festus
State: Missouri
ZIP Code: 63028-1952
Phone: (636) 931-2700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician	374700000X	Primary

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