Individual
MR. AUSTIN D HICKOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7901 ANGLING RD, PORTAGE, MI 49024-0714
(269) 324-8600
Mailing address
7901 ANGLING RD, PORTAGE, MI 49024-0714
(269) 324-8600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/15/2021
Last updated
07/13/2021
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