MEDICARE: JOYCE GAIL WIKOFF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide
2	3747P1801X	Personal Care Attendant	1891926755	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1891426755	OTHER	OH	NPI

General Provider Information

NPI Number	:	1891426755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCE GAIL WIKOFF

Provider Business Mailing Address
First Line	:	103 4TH ST W
Second Line	:
City	:	SOUTH POINT
State	:	OH
Zip	:	45680-9109
Country	:	US
Telephone Number	:	740-442-4106
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 4TH ST W
Second Line	:
City	:	SOUTH POINT
State	:	OH
Zip	:	45680-9109
Country	:	US
Telephone Number	:	740-442-4106
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2022
Last Update Date	:	06/23/2022

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Directions to “ JOYCE GAIL WIKOFF ” Practice Location

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