Individual
MR. JOHNNY LEE HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
381 LORVEN DR, LEXINGTON, NC 27292-8389
(336) 250-8260
Mailing address
381 LORVEN DR, LEXINGTON, NC 27292-8389
(336) 250-8260
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7330
NC
Other
Enumeration date
03/02/2010
Last updated
03/02/2010
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