| Hicks Chiropractic Center, Llc | |
|
501 W. Kieffer Rd., Michigan City, IN 46360-9580 | |
| (219) 879-2177 | |
| Not Available |
| Full Name | Hicks Chiropractic Center, Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor - Rehabilitation |
| Location | 501 W. Kieffer Rd., Michigan City, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588707053 | NPI | - | NPPES |
| 200431860A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 08001435A (Indiana) | Secondary |
| 111NR0400X | Chiropractor - Rehabilitation | 08001324 (Indiana) | Primary |
| Provider Name | Brent Hicks |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1073656534 PECOS PAC ID: 0941275531 Enrollment ID: I20111031000725 |
| Provider Name | Nicholas Lee Herbert |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1417340845 PECOS PAC ID: 5597085340 Enrollment ID: I20190122002146 |
| Provider Name | Grant Ferguson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1730631961 PECOS PAC ID: 1850670415 Enrollment ID: I20190226001073 |
| Mailing Address | Practice Location Address |
|---|---|
| Hicks Chiropractic Center, Llc 501 W. Kieffer Rd., Michigan City, IN 46360-9580 Ph: (219) 879-2177 | Hicks Chiropractic Center, Llc 501 W. Kieffer Rd., Michigan City, IN 46360-9580 Ph: (219) 879-2177 |
Dr. Brent Hicks, Chiropractor Medicare: Medicare Enrolled Practice Location: 501 W Kieffer Rd # 400n, Michigan City, IN 46360 Phone: 219-879-2177 | |
Dr. Justo Santos Samalio Iii, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 240 Commerce Sq, Michigan City, IN 46360 Phone: 210-872-2273 Fax: 219-872-5147 | |
Dr. Reilly D Enos, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 8690 W Pahs Rd, Michigan City, IN 46360 Phone: 219-872-5151 | |
Blake Olson, Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 501 W Kieffer Rd, Michigan City, IN 46360 Phone: 219-879-2177 | |
Scott Turner Glidden, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 8690 W Pahs Rd, Michigan City, IN 46360 Phone: 219-872-5151 Fax: 219-872-0177 | |
Ryan Johnston, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 501 W Kieffer Rd, Michigan City, IN 46360 Phone: 219-879-2177 | |
Dr. Matthew Robert Eaton, D.C Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 8690 W Pahs Rd, Michigan City, IN 46360 Phone: 219-872-5151 Fax: 219-872-0177 |