Individual
MRS. ANTONETTE B HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
134 N OLD DIXIE HWY, LADY LAKE, FL 32159-4347
(352) 751-6627
(352) 751-6628
Mailing address
2763 UNIVERSITY ACRES DR, ORLANDO, FL 32817-3015
(407) 282-9869
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0010599
FL
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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