Organization
WICKISER CLINIC OF CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY L WICKISER D.C. (OWNER)
(864) 224-0246
Entity
Organization
Contact information
Practice address
3618 E RIVER ST, ANDERSON, SC 29621-7334
(864) 224-0246
(864) 224-2524
Mailing address
3618 E RIVER ST, ANDERSON, SC 29621-7334
(864) 224-0246
(864) 224-2524
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CH2599
—
SC
05
—
GCH104
—
SC
Enumeration date
05/15/2007
Last updated
02/25/2008
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