Hickok, Larry A

Hickok, Larry A is an individual health care provider with primary practice located at 831 Dallas St , Chetek WI 54728-5811. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. Hickok, Larry A can be contacted via phone (800) 974-4378.

Contact Information

Primary practice address
831 Dallas St Chetek WI 54728-5811
Phone: (800) 974-4378
Fax: (630) 515-1536
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 4639-24 Wisconsin
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X 4639-02 Wisconsin

Profile Details

NPI number 1245304971
LBN Legal business name Hickok, Larry A
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2006
Last updated May 8th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245304971 NPPES
Wisconsin MEDICAID 40253000

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