Organization
LIFESTYLES CHIROPRACTIC
Active
Organization
LIFESTYLES CHIROPRACTIC
Active
Other names
LIFESTYLES CHIROPRACTIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD E WICKMANN D.C. (OWNER)
(239) 334-9355
Entity
Organization
Contact information
Practice address
11300 LINDBERGH BLVD, SUITE 110, FORT MYERS, FL 33913-8827
(239) 334-9355
(239) 334-9358
Mailing address
11300 LINDBERGH BLVD, SUITE 110, FORT MYERS, FL 33913-8827
(239) 334-9355
(239) 334-9358
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
CH9155
FL
Other
Enumeration date
12/27/2006
Last updated
05/14/2013
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