Individual
MRS. TIFFANY S. WICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFM
Contact information
Practice address
726 S SCALES ST, REIDSVILLE, NC 27320-5330
(336) 342-6474
(336) 342-7660
Mailing address
726 S SCALES ST, REIDSVILLE, NC 27320-5330
(336) 342-6474
(336) 342-7660
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740278167
NPI
NC
05
—
7795196
—
NC
Enumeration date
08/29/2007
Last updated
08/29/2007
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