Individual
BRADLEY JAMES HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
170 MEDICAL PARK RD STE 102, MOORESVILLE, NC 28117-8541
(704) 660-4750
(704) 660-4751
Mailing address
170 MEDICAL PARK RD, STE 102, MOORESVILLE, NC 28117-8541
(704) 660-4750
(704) 660-4751
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001004289
NC
Other
Enumeration date
06/12/2013
Last updated
10/19/2017
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