Mario Hickman

NPI #1144673922 in Detroit, Michigan

Provider Information

NPI Number: 1144673922
Entity Type: Individual
Name: Mario Hickman
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Driver
Enumeration Date: Jul 18, 2016
Last Updated: Jul 18, 2016

Practice Location

Address: 7465 POE ST
City: Detroit
State: Michigan
ZIP Code: 48206-2632
Phone: (313) 355-7801

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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