Individual
JOE ALLEN HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
805 HENRY ST, RAVENSWOOD, WV 26164-1221
(304) 532-9835
Mailing address
805 HENRY ST, RAVENSWOOD, WV 26164-1221
(304) 532-9835
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
24-9141
WV
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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