Individual
BRADY HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Contact information
Practice address
102 MAJOR ALLEN ST, MARTIN, SD 57551-6005
(605) 685-6622
Mailing address
PO BOX 345, MARTIN, SD 57551-0345
(605) 899-0099
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/08/2018
Last updated
08/16/2021
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