Doctor Name: | MARCIA L WICKWIRE |
NPI Number: | 1356408876 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MPT |
License Number: | PT-011081 |
Business Practice Address: | 2515 Lake Ave Ashtabula, OH - 440044955 |
Business Phone Number: | 4409976680 |
Business Fax Number: | 4409976311 |
Mailing Address: | 9803 Bateman Ave, CRANESVILLE |
State: | PA |
Postal Code: | 164101701 |
Phone Number: | 8144606706 |
Fax Number: | |
NPI Enumeration Date: | 01/03/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT-011081 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |