Lookup NPI Numbers from the NPI Registry
NPI Profile for JONATHAN WICKS in BLOOMINGTON, IN.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Sports Medicine |
2084S0010X | 86 | Physician/Neuropsychiatry |
| NPI # | 1003341918 |
|
| Status | Active | |
| Credentials | ATC, LAT, M.ED | |
| Entity | Individual | |
| Enumeration date | 04/28/2017 | |
| Last updated | 04/28/2017 - About 9 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JONATHAN WICKS
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JONATHAN WICKS, ATC, LAT, M.ED