Provider Demographics
NPI:1780964999
Name:WILCOX, RICHARD LYMAN (CP)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:LYMAN
Last Name:WILCOX
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Gender:M
Credentials:CP
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Mailing Address - Street 1:2425 STOCKTON BLVD
Mailing Address - Street 2:SUITE 236
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2215
Mailing Address - Country:US
Mailing Address - Phone:916-453-2170
Mailing Address - Fax:916-453-5024
Practice Address - Street 1:2425 STOCKTON BLVD
Practice Address - Street 2:SUITE 236
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2215
Practice Address - Country:US
Practice Address - Phone:916-453-2170
Practice Address - Fax:916-453-5024
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist