Individual
NOAH DICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
433 MAIN ST, LEAKESVILLE, MS 39451-6502
(601) 394-4545
(601) 394-4546
Mailing address
251 JOHNSTON ST SE STE 300, DECATUR, AL 35601-2515
(256) 350-1764
(256) 350-7757
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5709
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003819608
GROUP NPI
MS
05
—
529917620
—
MS
Enumeration date
09/09/2015
Last updated
09/09/2015
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