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Individual

JOSHUA J KICKHAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
4250 10TH ST, MENOMINEE, MI 49858-1312
(906) 863-8410
(906) 863-1242
Mailing address
601 S 32ND AVE, WAUSAU, WI 54401-3958
(715) 848-2526

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301009285
MI
111N00000X
Chiropractor
4231-012
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
144951704
UPHP
MI
05
144951704
MI
05
38969300
WI
Enumeration date
07/21/2006
Last updated
05/13/2008
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