NPI 1346843802

Walter Jordan Wickham, DPT

Practitioner Physical Medicine & Rehabilitation Physician Pocatello, ID

Practice location

Address: 1800 Flandro Dr STE 190, Pocatello, ID 83202-4940
Phone: (208) 233-2248

Registered specialties

Physical Medicine & Rehabilitation Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208100000X Licence PT-7106 (ID)

Other Physical Medicine & Rehabilitation providers in Idaho →

Registry record

NPI: 1346843802
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Nov 2020
Record last updated: 18 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.