Individual
DARRELL W HICKERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1300 VERTERANS BLVD., FESTUS, MO 63028
(636) 931-2100
Mailing address
625 ENTERPRISE DR., OAKBROOK, IL 60523
(630) 575-6250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
112723
MO
Other
Enumeration date
06/21/2007
Last updated
10/14/2019
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