| Wickiser Rehab & Wellness LLC | |
|
3618 E River St Anderson SC 29621-7334 | |
| (864) 224-0246 | |
| (864) 224-2524 |
| Full Name | Wickiser Rehab & Wellness LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 3618 E River St, Anderson, South Carolina |
| Authorized Official Name and Position | Clifton W Wickiser (PRESIDENT/OWNER) |
| Authorized Official Contact | 8642240246 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wickiser Rehab & Wellness LLC 3618 E River St Anderson SC 29621-7334 Ph: (864) 224-0246 | Wickiser Rehab & Wellness LLC 3618 E River St Anderson SC 29621-7334 Ph: (864) 224-0246 |
| NPI Number | 1053740852 |
|---|---|
| Provider Enumeration Date | 11/02/2013 |
| Last Update Date | 05/22/2024 |
| Certification Date | 05/22/2024 |
| Medicare PECOS PAC ID | 0345478582 |
|---|---|
| Medicare Enrollment ID | O20140114001148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053740852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD14473 (South Carolina) | Primary |
| Provider Name | Clifton W Wickiser |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1144309469 PECOS PAC ID: 9436208014 Enrollment ID: I20090602000065 |
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