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Organization

KARLA HICKS CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KARLA K HICKS (PRESIDENT)
(574) 232-3000
Entity
Organization

Contact information

Practice address
2610 E JEFFERSON BLVD, SOUTH BEND, IN 46615-2724
(574) 232-3000
(574) 236-4409
Mailing address
2610 E JEFFERSON BLVD, SOUTH BEND, IN 46615-2724
(574) 232-3000
(574) 236-4409

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000508824
BC/BS GROUP
IN
Enumeration date
01/29/2007
Last updated
08/23/2007
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