Individual
ERIC LYNN WICKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
965 ELLENDALE DR, MEDFORD, OR 97504-8215
(541) 734-3530
(253) 848-8567
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 734-3530
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60230
OR
Other
Enumeration date
10/19/2012
Last updated
06/24/2020
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