Individual
MR. JON GARY HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACY TECHNICIAN
Contact information
Practice address
146 THREE SONS DR, BIRMINGHAM, AL 35226-2961
(205) 824-9086
Mailing address
146 THREE SONS DR, BIRMINGHAM, AL 35226-2961
(205) 824-9086
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
T02361
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3201-0105-0766-335
PTCB
DC
Enumeration date
03/17/2008
Last updated
03/17/2008
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