NPI 1003203431

Ellen Myree Hicks, ATC

Practitioner Athletic Trainer Port Republic, VA

Practice location

Address: 5939 Flank Cir, Port Republic, VA 24471-2231
Phone: (540) 828-5368
Fax: (540) 515-3763

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 0126000363 (VA)

Other Specialist/Technologist providers in Virginia →

Registry record

NPI: 1003203431
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Apr 2015
Record last updated: 23 Apr 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.