Individual
DR. KENNETH LEE HICKS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
610 OLD TAR VILLAGE RD STE E, WINTERVILLE, NC 28590-7936
(252) 215-0990
(252) 215-0922
Mailing address
610 OLD TAR VILLAGE RD STE E, WINTERVILLE, NC 28590-7936
(252) 215-0990
(252) 215-0922
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2728
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890839U
—
NC
Enumeration date
11/16/2005
Last updated
01/23/2008
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