Individual
MATTHEW WICKERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5445 AVENUE O, FORT MADISON, IA 52627-9611
(660) 341-1684
Mailing address
5445 AVENUE O, FORT MADISON, IA 52627-9611
(660) 341-1684
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
074146
IA
2251X0800X
Orthopedic Physical Therapist
2015018854
MO
Other
Enumeration date
06/19/2014
Last updated
04/30/2020
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