Individual
MR. CHRISTOPHER M. WICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, OTR/L
Contact information
Practice address
2030 S PATRICK DR, STE 3, INDIAN HARBOUR BEACH, FL 32937-4400
(321) 773-8155
(321) 773-8154
Mailing address
2030 S PATRICK DR, STE 3, INDIAN HARBOUR BEACH, FL 32937-4400
(321) 773-8155
(321) 773-8154
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT20840
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K-3234
BEACHSIDE P.T. GROUP NUMBER
FL
01
—
PT-20840
STATE OF FL. PT LICENSE NUMBER
FL
Enumeration date
06/10/2006
Last updated
05/31/2011
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