Individual
MISS CHELSEA NICOLE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3758 SUPPER CLUB RD, LETART, WV 25253-8469
(304) 593-9518
Mailing address
3758 SUPPER CLUB RD, LETART, WV 25253-8469
(304) 593-9518
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
05/24/2015
Last updated
05/24/2015
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