Individual
THETA VICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
208 N MAIN ST STE 130, WEATHERFORD, TX 76086-3267
(817) 662-7800
Mailing address
208 N MAIN ST STE 130, WEATHERFORD, TX 76086-3267
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
07/27/2018
Last updated
07/27/2018
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