Individual
BRIAN LEWIS WIKE I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, DN
Contact information
Practice address
6320 W UNION HILLS DR STE A265, GLENDALE, AZ 85308-1098
(623) 374-2424
(623) 374-2619
Mailing address
6320 W UNION HILLS DR STE A265, GLENDALE, AZ 85308-1098
(623) 374-2424
(623) 374-2619
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
LPT-31722
AZ
2251X0800X
Orthopedic Physical Therapist
Primary
9772893-2401
UT
Other
Enumeration date
11/06/2017
Last updated
04/18/2025
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