Individual
KAITLYN MARIE HICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1163 7 LAKES DR, WEST END, NC 27376
(910) 673-5437
(910) 673-5438
Mailing address
PO BOX 354, WEST END, NC 27376-0354
(910) 673-5437
(910) 673-5438
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P22037
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P22037
PT LICENSE
NC
Enumeration date
03/03/2023
Last updated
03/03/2023
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