Larry A Hickok, PT | |
831 Dallas St, Chetek, WI 54728-5811 | |
(800) 974-4378 | |
(630) 515-1536 |
Full Name | Larry A Hickok |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 32 Years |
Location | 831 Dallas St, Chetek, Wisconsin |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245304971 | NPI | - | NPPES |
40253000 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 4639-24 (Wisconsin) | Primary |
2251X0800X | Physical Therapist - Orthopedic | 4639-02 (Wisconsin) | Secondary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Hickok Rehabilitation Services Llc | 0446355572 | 3 |
Provider Name | Hickok Rehabilitation Services Llc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1760424113 PECOS PAC ID: 0446355572 Enrollment ID: O20070419000078 |
Provider Name | Dpt Holdings Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1689648602 PECOS PAC ID: 4688679293 Enrollment ID: O20100708000581 |
Mailing Address | Practice Location Address |
---|---|
Larry A Hickok, PT 24014 W Renwick Rd Unit 206, Plainfield, IL 60544-8711 Ph: (800) 974-4378 | Larry A Hickok, PT 831 Dallas St, Chetek, WI 54728-5811 Ph: (800) 974-4378 |
Blue Hills Rehab And Fitness Studio Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1179 27th St, Chetek, WI 54728 Phone: 715-859-6580 Fax: 715-859-6588 | |
Sharon Ann Schumacher, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1179 27th St, Chetek, WI 54728 Phone: 715-859-6580 Fax: 715-859-6580 |