WALTER JORDAN WICKHAM DPT
Individual Provider (NPI-1)
Active
Physical Medicine & Rehabilitation
Provider Information
- NPI Number
1346843802- Provider Type
- Individual Provider (NPI-1)
- Credentials
- DPT
- Status
- Active
Contact & Location
- Address
- 1800 FLANDRO DR STE 190, POCATELLO, ID, 832024940
- Phone
- (208) 233-2248
Specialties & Taxonomies
Physical Medicine & Rehabilitation
Primary License: ID #pt-7106