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Individual
MR. THOMAS HOLLIDAY HICKS
Active
Individual
MR. THOMAS HOLLIDAY HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PR31129
SC
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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