Individual
HEIDI LOUISE WICKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 S BOULDER HWY, HENDERSON, NV 89015-8506
(702) 567-5454
(702) 567-5409
Mailing address
5630 NEOSHO ST, LAS VEGAS, NV 89120-4213
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16474
NV
Other
Enumeration date
10/25/2011
Last updated
10/25/2011
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