Individual
JEREMY MICHAEL HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 SAWMILL RD, RALEIGH, NC 27615-4320
(919) 848-7125
Mailing address
3634 SANA CT, DURHAM, NC 27713-1791
(919) 749-8775
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P21079
NC
Other
Enumeration date
02/15/2022
Last updated
02/15/2022
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