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General NPI Number Information
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NPI Number | 1982109773
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Entity Type | Individual
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Provider Name | JOSEPH HICKEY DC
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Gender | Male
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 09/27/2018
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Provider Practice Location Address
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Address Line | 2105 LAUREL BUSH RD STE 103
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City | BEL AIR
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State | MD
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Zip | 21015-6173
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Country | US
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Telephone | 443-512-0025
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Fax | 443-512-8844
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Provider Business Mailing Address
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Address Line | 10220 HICKORY RIDGE RD APT 301
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City | COLUMBIA
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State | MD
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Zip | 21044-4720
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Country | US
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Telephone | 570-956-5847
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | S03960
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License Number State | MD
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