Hicks, Brent

Hicks, Brent is an individual health care provider with primary practice located at 501 W Kieffer Rd # 400N , Michigan City IN 46360-9580. He recently has only one registered license in Chiropractic Providers / Rehabilitation, which is considered as his primary health care specialty. Hicks, Brent can be contacted via phone (219) 879-2177.

Contact Information

Primary practice address
501 W Kieffer Rd # 400N Michigan City IN 46360-9580
Phone: (219) 879-2177
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Rehabilitation 111NR0400X 08001324A Indiana

Profile Details

NPI number 1073656534
LBN Legal business name Hicks, Brent
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2007
Last updated Sep 30th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073656534 NPPES
Indiana MEDICAID 200431860A

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