Provider Demographics
NPI:1407521875
Name:HICKEY, COLIN STEVENS (DC)
Entity Type:Individual
Prefix:
First Name:COLIN
Middle Name:STEVENS
Last Name:HICKEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7555 OAK RIDGE HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-3342
Mailing Address - Country:US
Mailing Address - Phone:865-531-8025
Mailing Address - Fax:865-531-6480
Practice Address - Street 1:7555 OAK RIDGE HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-3342
Practice Address - Country:US
Practice Address - Phone:865-531-8025
Practice Address - Fax:865-531-6480
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3456111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor