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GEOFFREY VICKERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
1002 N WOODLAND DR, LANCASTER, SC 29720-1966
(803) 324-3745
Mailing address
1002 N WOODLAND DR, LANCASTER, SC 29720-1966
(803) 324-3745

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2234
SC
225200000X
Physical Therapy Assistant
3977
NC
225200000X
Physical Therapy Assistant
Primary
AT5834
CA

Other

Enumeration date
04/26/2012
Last updated
04/26/2012
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