Individual
SALLY TERESA VICKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2524 GLENN AVE, SIOUX CITY, IA 51106-2768
(712) 226-2253
(712) 226-2254
Mailing address
2514 CANTERBURY RD, SERGEANT BLUFF, IA 51054-9766
(712) 251-7029
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001498
IA
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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