Individual
TRAVIS HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1059 N 100 W, BEAVER, UT 84713-1690
(435) 438-7280
Mailing address
PO BOX 1690, BEAVER, UT 84713-1690
(435) 438-7280
(435) 438-7210
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1096261
NV
Other
Enumeration date
12/28/2010
Last updated
11/30/2012
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