| NPI | 1609555754 |
|---|---|
| Other Name | CODY HICKS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2785) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 2430) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2024-03-14 |