Individual
DR. JOHN C HICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
376 S LATAH ST, BOISE, ID 83705
(208) 338-9111
Mailing address
376 S LATAH ST, BOISE, ID 83705-1539
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1836
ID
Other
Enumeration date
04/09/2018
Last updated
04/09/2018
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