Individual
GARRETT J WICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
70110491
WI
363AM0700X
Medical Physician Assistant
Primary
587423
WI
Other
Enumeration date
03/21/2021
Last updated
08/25/2022
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