Kourtney Hicks, PTA

NPI #1669842035 in Crestwood, Illinois

Provider Information

NPI Number: 1669842035
Entity Type: Individual
Name: Kourtney Hicks, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Sep 29, 2015
Last Updated: Sep 29, 2015

Practice Location

Address: 5505 129TH PL
Address 2: APT 101
City: Crestwood
State: Illinois
ZIP Code: 60445-1241
Phone: (773) 412-0503

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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