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Individual

DR. PETER LORNE CONRAD HICKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
2300 GREAT NORTHERN AVE, SUITE B, MISSOULA, MT 59808-1678
(406) 549-7171
(406) 549-6868
Mailing address
2300 GREAT NORTHERN AVE, SUITE B, MISSOULA, MT 59808-1678
(406) 549-7171
(406) 549-6868

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1142
MS
111N00000X
Chiropractor
Primary
1207
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1336309731
NPI
MT
01
1861759011
NPI
MT
Enumeration date
06/10/2008
Last updated
09/22/2014
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