Provider Demographics
NPI:1154959096
Name:HICKS, WESTLEY (ACSM - RCEP)
Entity type:Individual
Prefix:
First Name:WESTLEY
Middle Name:
Last Name:HICKS
Suffix:
Gender:M
Credentials:ACSM - RCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10150 E VIRGINIA AVE UNIT 2-201
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1352
Mailing Address - Country:US
Mailing Address - Phone:970-593-8932
Mailing Address - Fax:
Practice Address - Street 1:10150 E VIRGINIA AVE UNIT 2-201
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-1352
Practice Address - Country:US
Practice Address - Phone:970-593-8932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist