Individual
JACOB BENJAMIN HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
451 LEE ST SW APT 5050B, ATLANTA, GA 30310-1408
(912) 381-4542
Mailing address
451 LEE ST SW APT 5050B, ATLANTA, GA 30310-1408
(912) 381-4542
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/03/2022
Last updated
01/03/2022
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