| NPI | 1063697910 |
|---|---|
| Former Name | BOBBETTE JEAN HICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251N0400X Physical Therapist, Neurology (Licence: OK 5560) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0011631) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2019-01-16 |