Individual
MACEY RICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
319 W CALL ST STE A, STARKE, FL 32091-3172
(904) 368-1257
Mailing address
8030 SE COUNTY ROAD 237, LAKE BUTLER, FL 32054-5847
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
29796
FL
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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