Individual
MRS. ADRIENNE SHIRLENE WICKENHEISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-5799
(701) 234-7451
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-5799
(701) 234-7451
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1838
ND
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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