Individual
DR. LAWRENCE ALLEN HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
47 PINE LAKE AVE, LA PORTE, IN 46350-3027
(219) 325-0404
Mailing address
84 S 362 W, VALPARAISO, IN 46385-9108
(219) 462-2744
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001631A
IN
Other
Enumeration date
09/29/2006
Last updated
09/28/2007
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