Individual
STEPHANIE WICKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
1400 BELLINGER ST., EAU CLAIRE, WI 54702-1510
(715) 838-6453
Mailing address
1400 BELLINGER ST., P.O. BOX1510, EAU CLAIRE, WI 54702-1510
(715) 838-6453
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1078-39
WI
Other
Enumeration date
12/14/2010
Last updated
10/27/2014
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