Individual
LISA WICKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1571 SPAULDING RD, DAYTON, OH 45432-3719
(937) 613-7921
Mailing address
1571 SPAULDING RD, DAYTON, OH 45432-3719
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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