Individual
WADE HICKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
214 KING ST, OGDENSBURG, NY 13669-1142
(315) 393-3600
Mailing address
214 KING ST, OGDENSBURG, NY 13669-1142
(315) 393-3600
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
012632
NY
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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