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General NPI Number Information
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NPI Number | 1114925328
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Entity Type | Individual
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Provider Name | CHRISTOPHER KIP HICKS CPO/LPO
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Gender | Male
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 909 FRANKLIN ST SE
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4333
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Country | US
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Telephone | 256-539-7997
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Fax | 256-539-7991
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Provider Business Mailing Address
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Address Line | 909 FRANKLIN ST SE
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4333
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Country | US
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Telephone | 256-539-7997
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Fax | 256-539-7991
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number | CPO 02437
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License Number State | DE
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