Individual
KIMBERLY NICOLE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
503 MORGANTOWN AVE, FAIRMONT, WV 26554-4388
(304) 363-7375
(304) 363-7376
Mailing address
22 KANAWHA ST, FAIRMONT, WV 26554-5278
(210) 716-3665
(304) 363-7376
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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