Individual
CLARENCE HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 HAMILTON POINTE DR, SUITE 115 & 120, BYRON, GA 31008
(478) 477-7531
Mailing address
164 SUMMER GROVE LN, MACON, GA 31206-5234
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
07/22/2013
Last updated
07/25/2013
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