| 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 Therapist In Private Practice |
| Experience | 33 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 |
|---|---|---|
| Dpt Holdings Llc | 4688679293 | 171 |
| 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 |