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Individual

BONNIE LEIGH WICKWIRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C. / N.D.

Contact information

Practice address
507 S RIVER ST, ENTERPRISE, OR 97828-1601
(541) 426-4502
Mailing address
603 MEDICAL PKWY, ENTERPRISE, OR 97828-5124
(541) 426-4502
(541) 426-6403

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2277
OR
175F00000X
Naturopath
Primary
0862
OR

Other

Enumeration date
07/09/2006
Last updated
04/17/2018
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