Individual
MICHAEL HICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14603 SW TEAL BLVD, BEAVERTON, OR 97007-6194
(971) 708-7193
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/01/2022
Last updated
04/01/2022
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