Individual
MARANDA HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
347 HWY 62 EAST COLLEGE PLAZA, MOUNTAIN HOME, AR 72653
(870) 701-5089
Mailing address
PO BOX 1266, MOUNTAIN HOME, AR 72654-1266
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4492
AR
Other
Enumeration date
11/21/2019
Last updated
11/21/2019
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