Individual
DR. HEATHER JO WICHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1900 SOUTH AVE, LA CROSSE, WI 54601-5467
(608) 775-6569
Mailing address
1900 SOUTH AVE, LA CROSSE, WI 54601-5467
(608) 775-6569
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
5751820
WI
2085R0202X
Diagnostic Radiology Physician
MD40484
IA
2085R0202X
Diagnostic Radiology Physician
PY58702
MN
2085R0204X
Vascular & Interventional Radiology Physician
Primary
5751820
WI
2085R0204X
Vascular & Interventional Radiology Physician
MD40484
IA
2085R0204X
Vascular & Interventional Radiology Physician
PY58702
MN
Other
Enumeration date
06/23/2008
Last updated
01/26/2015
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