Individual
MR. CHRISTOPHER KARL WICHERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1155 N MAYFAIR RD, SPINE CARE CLINIC, MILWAUKEE, WI 53226-3462
(414) 955-7199
(414) 955-0110
Mailing address
1155 N MAYFAIR RD, SPINE CARE CLINIC, MILWAUKEE, WI 53226-3462
(414) 955-7199
(414) 955-0110
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11483-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861700189
—
WI
01
—
859400071
MEDICARE
WI
Enumeration date
09/21/2010
Last updated
09/18/2014
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