Individual
JERRID HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
503 SILVER CROSS DR, BROOKHAVEN, MS 39601-2388
(601) 540-0497
Mailing address
503 SILVER CROSS DR, BROOKHAVEN, MS 39601-2388
(601) 540-0497
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA5335
MS
Other
Enumeration date
04/01/2014
Last updated
04/01/2014
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