# BRENT RICKS DPM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457749939
- **Authorized official:** DR. BRENT C RICKS DPM (CEO/CHAIRMAN OF THE BOARD)
- **Authorized official phone:** (209) 380-7760

## Contact information

- **Practice address:** 1601 MCHENRY VILLAGE WAY STE 3, MODESTO, CA 95350-4338
- **Practice address phone:** (209) 380-7760
- **Practice address fax:** (209) 526-3908
- **Mailing address:** 1601 MCHENRY VILLAGE WAY STE 3, MODESTO, CA 95350-4338
- **Mailing address phone:** (209) 380-7760
- **Mailing address fax:** (209) 526-3908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | E5055 | CA | Yes |

## Other

- **Enumeration date:** 01/06/2015
- **Last updated:** 01/06/2015