Individual
TEIRAH HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2756 NW 47TH LN, LAUDERDALE LAKES, FL 33313-2622
(954) 662-2467
Mailing address
2756 NW 47TH LN, LAUDERDALE LAKES, FL 33313-2622
(954) 662-2467
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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