Provider Demographics
NPI:1356413934
Name:DICKEY, JUSTIN CODY (DC)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:CODY
Last Name:DICKEY
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 1:132 SANCHEZ CREEK CT
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76088-3313
Mailing Address - Country:US
Mailing Address - Phone:817-613-6992
Mailing Address - Fax:
Practice Address - Street 1:119 S RANCH HOUSE RD
Practice Address - Street 2:SUITE 800
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-2694
Practice Address - Country:US
Practice Address - Phone:817-613-6992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10475111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor