Provider Demographics
NPI:1952701948
Name:HICKS, MEGAN A (PTA)
Entity Type:Individual
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First Name:MEGAN
Middle Name:A
Last Name:HICKS
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Gender:F
Credentials:PTA
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Mailing Address - Street 1:200 W DOUGLAS AVE
Mailing Address - Street 2:STE 1040
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-3013
Mailing Address - Country:US
Mailing Address - Phone:316-263-0003
Mailing Address - Fax:316-263-1241
Practice Address - Street 1:2243 S MERIDIAN AVE
Practice Address - Street 2:STE 105
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-1949
Practice Address - Country:US
Practice Address - Phone:316-942-5448
Practice Address - Fax:316-945-5694
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2021-11-24
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Provider Licenses
StateLicense IDTaxonomies
KS1402752225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant