Individual
STACY WICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-3684
Mailing address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
Taxonomy
Speciality
Code
Description
License number
State
208U00000X
Clinical Pharmacology Physician
Primary
063230
NY
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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