Individual
MARIO HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7465 POE ST, DETROIT, MI 48206-2632
(313) 355-7801
Mailing address
7465 POE ST, DETROIT, MI 48206-2632
(313) 355-7801
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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