Organization
HICKOK REHAB SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY A HICKOK PT (OWNER)
(715) 925-2471
Entity
Organization
Contact information
Practice address
831 DALLAS ST, CHETEK, WI 54728-5811
(715) 925-2471
Mailing address
831 DALLAS ST, CHETEK, WI 54728-5811
(715) 925-2471
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
4639-024
WI
Other
Enumeration date
03/10/2010
Last updated
03/10/2010
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