Individual
MR. CHARLES I HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
9807 BEACHVIE DR, JEROME, MI 49249-9551
(517) 688-4520
Mailing address
9807 BEACHVIEW DR, JEROME, MI 49249-9551
(517) 688-4520
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03210063
OH
Other
Enumeration date
08/23/2012
Last updated
08/23/2012
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