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Individual

DEREK WADE STICKLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
2447 S PRAIRIE AVE, PUEBLO, CO 81005-2886
(254) 394-0836
Mailing address
2447 S PRAIRIE AVE, PUEBLO, CO 81005-2886
(254) 394-0836

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6888
CO
111NR0400X
Rehabilitation Chiropractor
6888
CO

Other

Enumeration date
08/17/2012
Last updated
04/11/2018
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