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1568453801
LARRY CHARLES HICKS
MODESTO, CA
NPI
1568453801
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
Enumeration Date
2005-11-04
Last Update Date
2013-01-11
Business Address
-- LARRY CHARLES HICKS PA
1441 FLORIDA
MODESTO, CA 95352
Phone number: 209-576-3999
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Mailing Address
-- LARRY CHARLES HICKS PA
4301 NORTHSTAR WAY
MODESTO, CA 95356-9262
Phone number: 209-342-2300
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