Individual
JENNY FERN HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DOCTORATE OF PT
Contact information
Practice address
1905 PINE ST, SANDPOINT, ID 83864-8311
(208) 263-7998
Mailing address
1905 PINE ST, SANDPOINT, ID 83864-8311
(208) 263-7998
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
PT-260
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT-260
PHYSICAL THERAPY LICENSE NUMBER
ID
Enumeration date
05/17/2017
Last updated
08/16/2023
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