MEDICARE: JAMES SCOTT HICKS LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2236753	MN

General Provider Information

NPI Number	:	1124805437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES SCOTT HICKS LAC

Provider Business Mailing Address
First Line	:	836 7TH AVE SE
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55904-7334
Country	:	US
Telephone Number	:	763-360-7672
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 11TH AVE NW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55901-1805
Country	:	US
Telephone Number	:	507-285-1677
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2023
Last Update Date	:	09/11/2023

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Directions to “ JAMES SCOTT HICKS LAC” Practice Location

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