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Individual
JEAN HICKMAN
Active
Individual
JEAN HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
197524
NC
225100000X
Physical Therapist
Primary
040.0067009
VT
225100000X
Physical Therapist
6189
SC
225100000X
Physical Therapist
7406
NC
225100000X
Physical Therapist
PT3672
ME
Other
Enumeration date
07/29/2010
Last updated
07/29/2010
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