Provider Demographics
NPI:1982109773
Name:HICKEY, JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
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 1:10220 HICKORY RIDGE RD APT 301
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4720
Mailing Address - Country:US
Mailing Address - Phone:570-956-5847
Mailing Address - Fax:
Practice Address - Street 1:2105 LAUREL BUSH RD STE 103
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6173
Practice Address - Country:US
Practice Address - Phone:443-512-0025
Practice Address - Fax:443-512-8844
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03960111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor