Individual
JOHN HICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
323 DORCHESTER AVE, SOUTH BOSTON, MA 02127-2408
(617) 269-5600
(617) 269-5601
Mailing address
323 DORCHESTER AVE, SOUTH BOSTON, MA 02127-2408
(617) 269-5600
(617) 269-5601
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
4056
MA
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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