Individual
MR. CHRISTOPHER GORDON WICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.O.
Contact information
Practice address
7 WEBSTER SQUARE RD, BERLIN, CT 06037-2326
(860) 828-6684
(860) 828-1467
Mailing address
4 WESTER COURT, NEWINGTON, CT 06111
(860) 667-0199
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1380
CT
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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