MEDICARE: JEREMY ALEXANDER HICKS CMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1750801361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMY ALEXANDER HICKS CMT

Provider Business Mailing Address
First Line	:	183 LAS FLORES DR APT A
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91910-1972
Country	:	US
Telephone Number	:	619-519-3632
Fax Number	:

Provider Business Practice Location Address
First Line	:	183 LAS FLORES DR APT A
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91910-1972
Country	:	US
Telephone Number	:	619-519-3632
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2017
Last Update Date	:	07/21/2022

Similar Medicare Providers

1609709781 — NICHOLAS LANE GIBSON DC
Practice Location Address:

535 H ST
CHULA VISTA, CA
91910-4301

Practice Phone: 619-409-9000
Practice Fax:

1902778566 — GABRIELA JASMIN PEREZ
Practice Location Address:

310 3RD AVE STE B8
CHULA VISTA, CA
91910-3990

Practice Phone: 619-494-3177
Practice Fax:

1467467746 — WALGREEN CO
Practice Location Address:

621 I ST
CHULA VISTA, CA
91910-5110

Practice Phone: 619-407-4057
Practice Fax:

1518891373 — IYARIE MURGUIA
Practice Location Address:

660 BAY BLVD STE 110&111
CHULA VISTA, CA
91910-5200

Practice Phone: 866-727-8274
Practice Fax:

1891629515 — CHRISTIAN GRADY
Practice Location Address:

310 3RD AVE STE B8
CHULA VISTA, CA
91910-3990

Practice Phone: 619-494-3177
Practice Fax:

1265191662 — HANNA KOSTENKO
Practice Location Address:

310 3RD AVE STE B8
CHULA VISTA, CA
91910-3990

Practice Phone: 619-494-3177
Practice Fax:

Directions to “ JEREMY ALEXANDER HICKS CMT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.