Individual
MARY ELIZABETH WICKLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
142 JAMES MONROE DR, LINDSIDE, WV 24951-7168
(304) 753-5940
(304) 753-5941
Mailing address
PO BOX 590, UNION, WV 24983-0590
(304) 772-3064
(304) 772-3296
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/30/2017
Last updated
01/29/2025
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