Individual
NANCY E WICKSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
43 SKYTOP RD, IPSWICH, MA 01938-1476
(603) 502-3746
Mailing address
43 SKYTOP RD, IPSWICH, MA 01938-1476
(603) 502-3746
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8412
MA
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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