Individual
BENJAMIN HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
633 EMERSON RD, SUITE 20, CREVE COEUR, MO 63141-6739
(314) 325-3068
(314) 325-3069
Mailing address
633 EMERSON RD, SUITE 20, CREVE COEUR, MO 63141-6739
(314) 325-3068
(314) 325-3069
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2014028850
MO
Other
Enumeration date
12/29/2014
Last updated
09/27/2016
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