Individual
MR. DWAYNE EVERETT HICKS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1078 LAKE ROYALE, 129 CHOCTAW DRIVE, LOUISBURG, NC 27549
(252) 425-7746
Mailing address
1078 LAKE ROYALE, 129 CHOCTAW DRIVE, LOUISBURG, NC 27549
(252) 425-7746
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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