IndividualActive
Walter Wickham, DPT
NPI 1346843802 · Physical Medicine & Rehabilitation Physician · Pocatello, ID
Provider details
- NPI number
- 1346843802
- Entity type
- Individual
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Credential
- DPT
- Sex
- Male
- Sole proprietor
- No
- License
- PT-7106 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1800 Flandro Dr Ste 190
Pocatello, ID 83202-4940
Phone: (208) 233-2248
Approximate (ZIP-level) locationGet directions
Mailing address
1800 Flandro Dr Ste 190
Pocatello, ID 83202-4940
Registry dates
- Enumerated
- 2020-11-18
- Last updated
- 2020-11-18
- Certified
- 2020-11-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.