Organization
HICKS CHIROPRACTIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH LEE HICKS JR. D.C. (PRESIDENT)
(252) 412-2005
Entity
Organization
Contact information
Practice address
610 OLD TAR VILLAGE RD STE E, WINTERVILLE, NC 28590-7936
(252) 215-0990
Mailing address
610 OLD TAR VILLAGE RD STE E, WINTERVILLE, NC 28590-7936
(252) 215-0990
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2728
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890839U
—
NC
Enumeration date
09/13/2006
Last updated
01/23/2008
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