Individual
DR. DALE GORDON WICKLUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 E VETERANS ST, TOMAH, WI 54660-3105
(608) 372-3971
(608) 372-1205
Mailing address
15515 HELIX RD, TOMAH, WI 54660-6742
(608) 372-7173
(608) 372-1205
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25115
WI
Other
Enumeration date
07/16/2006
Last updated
07/08/2007
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