Wickliffe, Charles Wallace
Wickliffe, Charles Wallace is an sole proprietor health care provider with primary practice located at 11301 Wilshire Blvd 117R, Los Angeles CA 90073-1003. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Recreation Therapist, which is considered as his primary health care specialty. Wickliffe, Charles Wallace can be contacted via phone (310) 478-3711.Contact Information
Primary practice address
11301 Wilshire Blvd 117R
Los Angeles CA 90073-1003
Phone: (310) 478-3711
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Recreation Therapist | 225800000X |
Profile Details
| NPI number | 1871663054 |
|---|---|
| LBN Legal business name | Wickliffe, Charles Wallace |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 8th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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