Individual
COURTNEY BRYANNE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3006 HICKORY WOODS DR NE APT 122, ROANOKE, VA 24012-6362
(304) 910-6348
Mailing address
3006 HICKORY WOODS DR NE APT 122, ROANOKE, VA 24012-6362
(304) 910-6348
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/27/2019
Last updated
06/27/2019
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