Individual
TRE'QUON MARQUIS HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CTRS
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Mailing address
5519 N EDWARDS CIR, WICHITA, KS 67204-5400
(706) 505-0880
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
84088
AL
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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