Jeremy Michael Hicks
Physical Therapist in Raleigh, NC. Individual provider (NPI-1).
NPI number1831844232
StatusActive
Last updated in NPPESFeb 15, 2022
Details
- NPI
- 1831844232
- Entity type
- Individual (NPI-1)
- Name
- Jeremy Michael Hicks
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 15, 2022
- Certification date
- Feb 15, 2022
- Last updated
- Feb 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | P21079 | NC | Yes |
Practice location
1500 Sawmill RdRaleigh, NC 27615-4320
Phone 919-848-7125
Mailing address
3634 Sana CtDurham, NC 27713-1791
Phone 919-749-8775
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