Individual
BARBARA TRAVIS HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5270
Mailing address
164 CHIPPEWA ST, CLAWSON, MI 48017-2093
(248) 835-9578
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
24119
MI
Other
Enumeration date
06/01/2007
Last updated
07/08/2007
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