Individual
RYAN WICKERHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9862 46TH AVE NE 1191 KENT ADDITION, 1191, BELCOURT, ND 58316
(701) 278-1111
(701) 477-8507
Mailing address
PO BOX 2263, BELCOURT, ND 58316-2263
(701) 278-1111
(701) 477-8507
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
10/31/2020
Last updated
10/31/2020
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