Individual
MR. KENNETH RILEY HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1104 EAST GRACE ST, JASPER COUNTY HOSPITAL, RENSSELAER, IN 47978-3211
(219) 866-5141
(219) 866-3234
Mailing address
1104 EAST GRACE ST, RENSSELAER, IN 47978-3211
(219) 866-5141
(219) 866-3234
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000117A
IN
Other
Enumeration date
05/23/2006
Last updated
07/13/2026
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