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Individual

MRS. JENNIFER LYNN WICKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
360 HARBISON BLVD, COLUMBIA, SC 29212-2248
(803) 732-6230
Mailing address
832 STOCKMAN RD, PROSPERITY, SC 29127-9474
(803) 944-0873

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1255
SC

Other

Enumeration date
12/12/2024
Last updated
12/12/2024
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