Individual
MAXIMILLIEN DAMIEN HICKOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
309 W 3RD ST, GROVE, OK 74344-3205
(918) 787-6116
Mailing address
309 W 3RD ST, GROVE, OK 74344-3205
(918) 787-6116
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2026027417
MO
225700000X
Massage Therapist
209785
OK
Other
Enumeration date
06/16/2026
Last updated
07/19/2026
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